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Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 5

TEG Parameters Maximum Amplitude, Reaction Time Predicts Sepsis-Induced Coagulopathy and Mortality: A Prospective, Observational Study

Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China

Correspondence Address:
Xiaojuan Zhang
Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jtccm.jtccm_8_21

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Introduction: The diagnostic and prognostic value of thromboelastogram (TEG) in sepsis has not been determined. This study aimed to assess whether TEG is an early predictor of coagulopathy and is associated with mortality in patients with sepsis. Methods: In total, 518 patients with sepsis on the intensive care unit (ICU) admission were prospectively evaluated. We measured TEG and conventional coagulation tests on preadmission to ICU and observed for the development of 1 and 3 days and 1, 3, and 7 days, respectively. Multivariable logistic regression was utilized to determine the odds of ICU/hospital mortality. The parameter of TEG (maximum amplitude, reaction time; MA/R ratio) was calculated to evaluate sepsis-induced coagulopathy. The patients were divided into three groups : MA/R0 group (MA/R = 5–14 mm/min); MA/R1 group (MA/R <5 mm/min); and MA/R2 group (MA/R >14 mm/min). Results: Four hundred and ten patients were included. At enrolment, 10.73%, 65.85%, and 23.41% of the patients had lower, normal, and higher MA/R state, respectively. Compared to MA/R0 group, patients with lower and higher MA/R both had significantly increase risk of hospital mortality (hazards ratio [HR] 2.83 [95% confidence interval [CI] 1.577–5.079], P < 0.01); (HR 1.982 [95% CI 1.073–3.66], P = 0.029), respectively (adjusted with Acute Physiology and Chronic Health Evaluation [APACHEII] score) and ICU mortality (HR 2.512 [95% CI 1.301–4.852], P = 0.006); (HR1.644 [95% CI 1.024–2.639], P = 0.002) (adjusted with APACHEII score). Patients with higher MA/R had significantly increase risk of hospital mortality APACHE II score (HR 1.635 [95% CI 1.016–2.632], P = 0.043). Conclusions: In our cohort of patients with severe sepsis, coagulopathy defined by MA/R ratio was associated with increased risk of ICU/hospital mortality.

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