Establishing a normal reference range for thromboelastography in North Indian healthy volunteers

Area of Science:

• Hematology
• Coagulation Diagnostics

Background:

• Thromboelastography (TEG) offers real-time coagulation analysis but lacks established reference values for the Indian population.
• Limited published literature exists on TEG assessment in this demographic.

Purpose of the Study:

• To determine normal TEG reference values in healthy North Indian adults.
• To compare these values with conventional coagulation tests and manufacturer-provided ranges.

Main Methods:

• 200 healthy volunteers (100 male, 100 female) aged 20-50 years were enrolled.
• Thromboelastometry (TEM) was performed using whole blood on a TEM-A analyzer.
• Key TEG parameters (r-time, k-time, α-angle, MA) were analyzed; PT, aPTT, and platelet counts were also measured.

Main Results:

• Established 95% reference ranges: r-time (1.8-14.2 min), k-time (0.7-7.3 min), α-angle (27.3-72.3°), MA (32.1-87.9 mm).
• Significant variations (P < 0.001) were observed between manufacturer and derived reference ranges for all TEG parameters.
• Manufacturer ranges identified 74% of volunteers as having deranged TEG values, suggesting oversensitivity.

Conclusions:

• Manufacturer TEG reference values may not be appropriate for the North Indian population due to ethnic variations.
• TEG is sensitive but may overdiagnose coagulopathy without clinical correlation and cannot replace conventional tests.
• Laboratories should establish their own normal TEG values for their specific populations.