Evaluation of activated partial thromboplastin time coagulation waveform analysis for identification of patients with acquired factor VIII inhibitors

• DOI: 10.1111/ijlh.13211
• Publication Date: 2020-04-16T07:43:35Z
• Authors: Eric McGinnis; Steven K. W. Wong; Tyler W. Smith
• Keywords: Thromboplastin; Prothrombin time; Thromboelastography

Abstract Introduction Activated partial thromboplastin time (PTT) coagulation waveforms produced by optical detection system analyzers provide additional potentially useful and routinely underutilized information for the evaluation of a patient's system. We aimed to identify features PTT waveforms, available all assays performed in our hospital laboratories, that may prove directing early investigations patients with unexplained prolonged PTT. Methods retrospectively reviewed 211 from patient testing categorized them based on underlying hemostatic abnormality: normal, therapeutic anticoagulation, lupus anticoagulant, congenital factor deficiency, or acquired VIII inhibitor. compared quantitative waveform parameters frequency qualitatively abnormal double‐peaked first derivative curves between these groups. Results Partial curve maxima minima differed significantly inhibitors other diagnostic categories, second minimum demonstrated highest area under receiver operator characteristic identification (0.860; maximum accuracy: 79.5% 2Dmin> −39.3 mAbs/s 2 [sensitivity 90.5%; specificity 77.2%]). The presence an had sensitivity 83.3% 81.6% cases >50 seconds. Conclusion analysis can aid be clinical utility laboratory at risk severe bleeding without prompt intervention.