Prediction of Mid-term Platelet Transfusion in Stable Trauma Patients Using Rotational Thromboelastometry

Area of Science:

• Coagulation diagnostics
• Trauma patient management
• Transfusion medicine

Background:

• Rotational thromboelastometry (ROTEM) is a global coagulation test used in guiding platelet transfusions for trauma patients.
• Predicting the need for mid-term platelet transfusions in trauma patients is crucial for effective management.

Purpose of the Study:

• To evaluate the predictive capability of ROTEM parameters for mid-term (five-day) platelet transfusion requirements in trauma patients.
• To assess the correlation of ROTEM parameters with conventional coagulation tests.

Main Methods:

• Retrospective analysis of ROTEM parameters (FIBTEM, EXTEM, PLTEM) from 82 hospitalized trauma patients post-resuscitation.
• Maximum clot firmness and clot amplitudes (A5, A10, A15) were analyzed.
• Platelet transfusion data was reviewed for five days post-ROTEM analysis.

Main Results:

• FIBTEM and EXTEM demonstrated high predictive accuracy (AUC 0.915-0.923 and 0.878-0.896, respectively) for predicting >12 U platelet concentrate transfusion.
• PLTEM showed moderate predictive value (AUC 0.551-0.735).
• Strong correlations were observed between platelet count and EXTEM/PLTEM, platelet function and EXTEM, and fibrinogen levels and FIBTEM parameters.

Conclusions:

• FIBTEM and EXTEM are reliable tools for predicting mid-term platelet transfusion needs in trauma patients.
• ROTEM parameters correlate with conventional coagulation tests, including platelet counts and fibrinogen levels.