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. 2021 Jan-Dec:27:10760296211047231.
doi: 10.1177/10760296211047231.

Diagnostic Value of Thromboelastography (TEG) for the Diagnosis of Death in Infected Patients

Jingchao Xuan  1 , Junyu Wang  1 , Bing Wei  1
Affiliations

Diagnostic Value of Thromboelastography (TEG) for the Diagnosis of Death in Infected Patients

Jingchao Xuan et al. Clin Appl Thromb Hemost. 2021 Jan-Dec.

Abstract

In this study, we want to investigate the clinical value of each index of thromboelastography (TEG) on the prognosis of infected patients.The clinical baseline data and TEG test results of 431 infected patients in our hospital's emergency department between January 2018 and December 2018 were selected. And the patients were divided into death and survival groups to analyze the predictive value of each index of TEG and the joint model on the death of infected patients.In the correlation study of C-reactive protein (CRP) and procalcitonin (PCT) with each TEG parameter, CRP was positively correlated with maximum amplitude (MA, r = 0.145, P = .003) and elasticity constants (E, r = 0.098, P = .043), respectively. PCT was positively correlated with coagulation reaction time (R, r = 0.124, P = .010) and time to MA (TMA) (r = 0.165, P = .001), respectively; PCT was negatively correlated with α-Angle (r = 0.124, P = .010) and coagulation index (CI, r = -0.108, P = .026), respectively. Multifactorial regression analysis showed that granulocytes, thrombocytes, platelet distribution width (PDW), and infection site were independent influences on infected patients' death. Diagnostic data showed that all eight TEG indicators had good specificity for predicting death, but all had poor sensitivity; thrombodynamic potential index (TPI) had the best diagnostic value (area under the curve, AUC = 0.609, P = .002). The eight-indicator modeling of TEG showed that the TEG model combined with PCT and CRP, respectively, had lower diagnostic efficacy than PCT (AUC = 0.756, P < .001); however, TEG had better specificity (82.73%) when diagnosed independently.The granulocytes, thrombocytes, PDW, and infection site are independent influencing factors of death in infected patients. Each index of TEG has better specificity in the diagnosis of death in infected patients.

Keywords: coagulation function; death; diagnosis; infection; thromboelastography.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comparison of baseline information between patients in the infection death group and the non-death group. A. Age; B. The number of granulocytes; C. The number of lymphocytes; D. NLR; E. The number of platelets; F. The PDW; G. Measured CPR; H. Measured values of PCT.
Figure 2.
Figure 2.
Comparison of the TEG parameter between patients in the infection death group and the nondeath group. A. Measured K values; B. Measured α-Angle values; C. Measured MA values; D. Measured CI values. E. Measured E values. F. Measured TPI values.
Figure 3.
Figure 3.
Correlation analysis between TEG parameter and CRP, and PCT. A. CRP and MA; B. E and MA; C. PCT and R; D. PCT and TMA; E. PCT and α-Angle; F. PCT and CI.
Figure 4.
Figure 4.
The AUC diagnostic results of the TEG parameter.
Figure 5.
Figure 5.
The result of the AUC between the TEG model, CPR, CRP, and SOFA scores.
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