The role of rapid thromboelastography in trauma

Evaluation of: Hampton DA, Lee TH, Diggs BJ, McCully SP, Schreiber MA. A predictive model of early mortality in trauma patients. Am. J. Surg. 207(5), 642-647 (2014). In their prospective multi-centred observational study, Hampton et al. tested the ability of rapid thromboelastography (r-TEG) to predict mortality in trauma patients. A total of 795 patients were assessed. The authors analysed both patient demographic and physiological measures. Validation of variables that significantly related to mortality was subsequently undertaken. Ly30 (a measurement of the degree of clot lysis over 30 min) was observed to be a predictor of 24-h mortality in trauma (odds ratio 3.7 p = 0.03). This was incorporated with haemoglobin level, international normalized ratio, Glasgow Coma Score and the presence of penetrating injury to form their five-variable mortality prediction model. Hampton et al. conclude that the correlation between r-TEG measurements and trauma mortality makes it a useful tool in mortality prediction. The report highlights the importance of using this point-of-care coagulation assessment machine in mortality prediction for trauma patients.