Comparison of conventional coagulation tests and ROTEM in identifying trauma‐induced coagulopathy for massive haemorrhage protocol activation

• DOI: 10.1111/tme.13128
• Publication Date: 2025-01-25T08:44:35Z
• Authors: Sakara Hutspardol; Tyrone Borja; Jenna Kroeker; Xiu Qing Wang; Jian Mi; David Zamar; Geoffrey Chan; Tyler Smith; Harvey Hawes; Andrew W. Shih
• Keywords: Thromboelastometry; Coagulation testing

Abstract Objectives Trauma‐induced coagulopathy (TIC) can be fatal but preventable if recognised early. With emerging uses of rotational thromboelastometry (ROTEM) to guide transfusions in trauma, patient outcomes with TIC‐defined by initial ROTEM and conventional coagulation tests (CCTs) during massive haemorrhage protocol (MHP) activations were evaluated at a primary trauma centre British Columbia. Methods This retrospective observational study included adult patients requiring MHP from June 1, 2020, May 31, 2022. TIC, defined results including (1) ROTEM‐based EXTEM A10 <40 mm, CT >100 s, ML30 >10%, FIBTEM <10 mm; (2) CCT‐based INR ≥1.8, PTT ≥1.5 times upper normal limit, platelets <50 x 10 9 /L, Clauss Fibrinogen <1.5 g/L, was assessed for its correlation mortality. Modified Poisson regression used model 28‐day Results Twenty‐two sixty‐eight (32%) had abnormal CCTs. TIC CCTs associated increased mortality [24 h: 5/13 (38%) vs. 5/55 (9%), p = 0.025; 28d: 8/13 (62%) 11/55 (20%), 0.002]; compared ROTEM, which not 7/35 (20%) 3/33 0.307; 11/35 (31%) 9/33 (27%), 0.594], despite significantly higher blood component transfusion within the first 4 24 h ( ‐values<0.05). Conclusions is more sensitive identifying TIC. Patients death rate, those no A prospective required assess effects further.