Observational studyTransfusion medicine (Oxford, England)2025
Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.
Observational study in Transfusion medicine (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Precision-guided tranexamic acid administration in total hip arthroplasty: integrating viscoelastic testing and patient risk stratification into perioperative hemostasis - a narrative review.Annals of medicine and surgery (2012) · 2026Review
- [Construction of an Early-stage Risk Prediction Model for Trauma-Induced Coagulopathy].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2026Article
- Trauma-Induced Coagulopathy: A Review of Specific Molecular Mechanisms.Diagnostics (Basel, Switzerland) · 2025Review
- Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.Transfusion medicine (Oxford, England) · 2025Observational
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTrauma-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 in British Columbia.
methodsThis retrospective observational study included adult trauma patients requiring MHP from June 1, 2020, to May 31, 2022. TIC, defined by initial results including (1) ROTEM-based EXTEM A10 <40 mm, EXTEM CT >100 s, EXTEM ML30 >10%, FIBTEM A10 <10 mm; and (2) CCT-based INR ≥1.8, PTT ≥1.5 times of upper normal limit, platelets <50 x 10
resultsTwenty-two of sixty-eight patients (32%) had abnormal ROTEM but normal CCTs. TIC defined by CCTs was associated with increased mortality [24 h: 5/13 (38%) vs. 5/55 (9%), p = 0.025; 28d: 8/13 (62%) vs. 11/55 (20%), p = 0.002]; compared to ROTEM, which was not [24 h: 7/35 (20%) vs. 3/33 (9%), p = 0.307; 28d: 11/35 (31%) vs. 9/33 (27%), p = 0.594], despite requiring significantly higher blood component transfusion within the first 4 and 24 h of MHP (p-values<0.05).
conclusionsROTEM is more sensitive in identifying TIC. Patients with abnormal CCTs had a higher death rate, and those with abnormal ROTEM had no significantly increased mortality. A prospective study is required to assess the effects of ROTEM further.
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