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Related Experiment Video

Updated: Nov 1, 2025

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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Thromboelastograph:A prognostic marker in sepsis with organ dysfunction without overt bleeding.

Fibi Ninan K1, Ramya Iyadurai1, Justin K Varghese2

  • 1Department of Medicine, Christian Medical College (CMC), Vellore, India.

Journal of Critical Care
|June 25, 2021
PubMed
Summary

In severe sepsis without bleeding, a hypocoagulable state identified by thromboelastogram (TEG) is linked to increased mortality. This finding highlights the importance of TEG in predicting outcomes for sepsis patients.

Keywords:
CoagulopathySepsisThromboelastograph

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Pathophysiology

Background:

  • Coagulation abnormalities are common in sepsis.
  • The prognostic significance of thromboelastogram (TEG) findings in severe sepsis without overt bleeding remains unclear.

Purpose of the Study:

  • To investigate the association between TEG-defined coagulation states and mortality in patients with severe sepsis without overt bleeding.

Main Methods:

  • Prospective study categorizing patients into normal, hypercoagulable, or hypocoagulable states based on admission TEG parameters (R time, K time, MA, α angle).
  • Statistical analysis using Fisher's exact and Mann-Whitney U tests to explore associations with mortality.

Main Results:

  • The study included 87 patients with severe sepsis; mortality was 24.1%.
  • A significant proportion of patients (26.7-29.9%) exhibited a hypocoagulable state.
  • Prolonged R time and reduced alpha angle in the hypocoagulable state were associated with increased mortality (p=0.04 and p=0.01, respectively).
  • TEG parameters (K time, α angle, MA) differed significantly in patients requiring transfusion (p < 0.001).

Conclusions:

  • Severe sepsis patients without overt bleeding can present with a hypocoagulable state.
  • Hypocoagulability, as indicated by specific TEG parameters, is associated with higher mortality and the need for blood transfusion.