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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
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Thromboelastography Better Reflects Hemostatic Abnormalities in Cirrhotics Compared With the International Normalized
Justine Hum1, Deron Amador1, Joseph J Shatzel2,3
1Divisions of Gastroenterology and Hepatology.
Journal of Clinical Gastroenterology
|November 26, 2019
Summary
Thromboelastography (TEG) shows cirrhotic patients have altered coagulation, with parameters worsening as liver disease progresses. Unlike traditional tests, TEG may better predict bleeding risk in cirrhosis.
Area of Science:
- Hepatology
- Hematology
- Coagulation Science
Background:
- Thromboelastography (TEG) is a functional coagulation assay.
- It is increasingly used to predict bleeding risk in cirrhosis patients.
Purpose of the Study:
- Compare TEG variables in hospitalized cirrhotics versus healthy individuals.
- Identify hematologic disturbance patterns with cirrhosis progression.
- Assess traditional tests (INR, platelet count) for coagulopathy in cirrhotics.
Main Methods:
- Included 106 hospitalized cirrhotics and 53 healthy controls.
- Measured TEG parameters (r-time, k-time, α, maximum amplitude) using kaolin-activated citrated blood.
- Compared TEG data with international normalized ratio (INR) and platelet counts.
Main Results:
- TEG parameters differed significantly between cirrhotics and controls.
- Cirrhotic TEG parameters were mostly within normal ranges, unlike INR and platelet counts.
- R-time, k-time, and α increased, while maximum amplitude decreased with liver disease severity.
- No significant correlation found between INR and TEG r-time across Child-Turcotte-Pugh classes.
Conclusions:
- Cirrhotic patients exhibit altered clot formation, worsening with liver disease.
- TEG parameters, though often within normal ranges, indicate impaired coagulation.
- International normalized ratio (INR) did not correlate with TEG findings in cirrhotics.
- TEG may offer superior prediction of bleeding risk compared to traditional tests in cirrhosis.
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