Observational studyIntensive care medicine2015
Thromboelastography in patients with severe sepsis: a prospective cohort study.
Observational study in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00962156 (Effects of Hydroxyethyl Starch 130/0.4 Compared With Balanced Crystalloid Solution on Mortality and Kidney Failure in Patients With Severe Sepsis), which is not on this map. Cited by 33 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Hydroxyethyl Starch 130/0.4 Compared With Balanced Crystalloid Solution on Mortality and Kidney Failure in Patients With Severe Sepsis
Who cites it
33 citing papers in PubMed, 80 citations in OpenAlex.
- Categorizing Sepsis-induced Coagulopathy Using Thromboelastography: An Approach to Address the Second Pillar of Patient Blood Management.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Sepsis-induced coagulopathy (SIC) in the management of sepsis.Annals of intensive care · 2025Article
- Disseminated intravascular coagulation: cause, molecular mechanism, diagnosis, and therapy.MedComm · 2025Review
- Comparison of thromboelastographic profiles and clinical characteristics in children with severe Mycoplasma pneumoniae pneumonia.Frontiers in pediatrics · 2025Article
- Procalcitonin and qSOFA as a Marker of Mortality in Sepsis.Reviews on recent clinical trials · 2024Observational
- Coagulation Disorders in Sepsis and COVID-19-Two Sides of the Same Coin? A Review of Inflammation-Coagulation Crosstalk in Bacterial Sepsis and COVID-19.Journal of clinical medicine · 2023Review
- Role of thromboelastography in the evaluation of septic shock patients with normal prothrombin time and activated partial thromboplastin time.Scientific reports · 2021Observational
- Coagulopathy in COVID-19.Lung India : official organ of Indian Chest Society · 2021Review
- Role of Thromboelastography as an Early Predictor of Disseminated Intravascular Coagulation in Patients with Septic Shock.Journal of clinical medicine · 2020Article
- Review
- Thromboelastography Profiles of Critically Ill Patients With Coronavirus Disease 2019.Critical care medicine · 2020Article
- Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations.American journal of respiratory and critical care medicine · 2020Observational
- Comparison of the proximal and distal approaches for axillary vein catheterization under ultrasound guidance (PANDA) in cardiac surgery patients susceptible to bleeding: a randomized controlled trial.Annals of intensive care · 2020Article
- [Progress in quantitative diagnosis of sepsis-induced disseminated intravascular coagulation].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2020Article
- The prognostic role of ThromboDynamic Index in patients with severe sepsis.Internal and emergency medicine · 2020Article
- TEG in the monitoring of coagulation changes in patients with sepsis and the clinical significance.Experimental and therapeutic medicine · 2019Article
- Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review.The journal of trauma and acute care surgery · 2019Review
- Thromboelastography Variables, Immune Markers, and Endothelial Factors Associated With Shock and NPMODS in Children With Severe Sepsis.Frontiers in pediatrics · 2019Article
- Review: The Perioperative Use of Thromboelastography for Liver Transplant Patients.Transplantation proceedings · 2018Review
- Risks of bleeding and thrombosis in intensive care unit patients with haematological malignancies.Annals of intensive care · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the association between consecutively measured thromboelastographic (TEG) tracings and outcome in patients with severe sepsis.
methodsMulticentre prospective observational study in a subgroup of the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) Trial (NCT00962156) comparing hydroxyethyl starch (HES) 130/0.42 vs. Ringer's acetate for fluid resuscitation in severe sepsis. TEG (standard and functional fibrinogen) was measured consecutively for 5 days, and clinical data including bleeding and death was retrieved from the trial database. Statistical analyses included Cox regression with time-dependent covariates and joint modelling techniques.
resultsOf 267 eligible patients, we analysed 260 patients with TEG data. At 90 days, 68 (26 %) had bled and 139 (53 %) had died. For all TEG variables, hypocoagulability according to the reference range was significantly associated with increased risk of death. In a linear model, hazard ratios for death were 6.03 (95 % confidence interval, 1.64-22.17) for increased clot formation speed, 1.10 (1.04-1.16) for decreased angle, 1.09 (1.05-1.14) for decreased clot strength and 1.12 (1.06-1.18) for decreased fibrinogen contribution to clot strength (functional fibrinogen MA), showing that deterioration towards hypocoagulability in any TEG variable significantly increased the risk of death. Patients treated with HES had lower functional fibrinogen MA than those treated Ringer's acetate, which significantly increased the risk of subsequent bleeding [HR 2.43 (1.16-5.07)] and possibly explained the excess bleeding with HES in the 6S trial.
conclusionsIn our cohort of patients with severe sepsis, progressive hypocoagulability defined by TEG variables was associated with increased risk of death and increased risk of bleeding.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.