Sta Ines Mars Christian A, Khalid Usman I, Shah Muhmmad H
Medical Education and Emergency Medicine, University Hospital Coventry, Coventry, GBR.
Trauma and Orthopaedics, Royal Victoria Hospital, Belfast, GBR.
Cureus. 2025 Jul 14;17(7):e87890. doi: 10.7759/cureus.87890. eCollection 2025 Jul.
Background Trauma-induced coagulopathy (TIC) has a crucial impact on the outcome and death rate in people suffering from trauma. This study aimed to evaluate the speed, reliability, and treatment decisions of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) use in emergency trauma cases. Methods This prospective observational study was used to investigate 60 trauma patients with suspected coagulopathy. TEG and ROTEM measured clot initiation, its formation, strength, and lysis, along with the more common lab coagulation tests (prothrombin time, activated partial thromboplastin time, and platelet counts). All tests were performed to compare blood transfusion status, fibrinogen, antifibrinolytic use, and the timing of surgery. To assess the comparisons, Student's t-test and chi-square analysis were both carried out with a significant p-value of <0.05. Results Both TEG and ROTEM effectively assessed coagulopathy. ROTEM measured results faster, with a mean time of 24 minutes, compared to TEG with a mean time of 31 minutes (p<0.001). It was found that ROTEM resulted in quicker clotting time and clot formation (both p-values were 0.01 and 0.03). Patients under ROTEM treatment were treated and operated on sooner than those in the TEG group. However, there were no significant variations found in transfusion and fibrinogen use in TEG and ROTEM groups. Conclusion Both TEG and ROTEM can give reliable information about trauma patients' coagulopathy. With ROTEM, the results were obtained rapidly, and doctors were able to make clinical decisions faster in critical care cases. Even though clot test results were slightly different, both types of assays helped with better resuscitation for each patient.
背景 创伤性凝血病(TIC)对创伤患者的预后和死亡率有着至关重要的影响。本研究旨在评估在急诊创伤病例中使用血栓弹力图(TEG)和旋转血栓弹力测定法(ROTEM)的速度、可靠性及治疗决策。方法 本前瞻性观察性研究用于调查60例疑似凝血病的创伤患者。TEG和ROTEM测量凝血起始、形成、强度和溶解情况,以及更常见的实验室凝血检测(凝血酶原时间、活化部分凝血活酶时间和血小板计数)。所有检测均用于比较输血状态、纤维蛋白原、抗纤溶药物的使用及手术时机。为评估比较结果,采用了学生t检验和卡方分析,显著性p值<0.05。结果 TEG和ROTEM均能有效评估凝血病。ROTEM测量结果更快,平均时间为24分钟,而TEG的平均时间为31分钟(p<0.001)。发现ROTEM导致凝血时间和凝块形成更快(p值均为0.01和0.03)。接受ROTEM治疗的患者比TEG组患者接受治疗和手术的时间更早。然而,TEG组和ROTEM组在输血和纤维蛋白原使用方面未发现显著差异。结论 TEG和ROTEM均能提供有关创伤患者凝血病的可靠信息。使用ROTEM时,结果获取迅速,医生能够在重症监护病例中更快地做出临床决策。尽管凝血检测结果略有不同,但两种检测方法都有助于为每位患者进行更好的复苏。