Rotational thromboelastometry predicts future bleeding events in patients with cirrhosis

Area of Science:

• Hepatology
• Haematology
• Clinical Diagnostics

Background:

• Patients with cirrhosis have imbalanced haemostasis, increasing risks of bleeding and thrombosis.
• Conventional tests fail to predict these complications in cirrhosis patients.
• Rotational Thromboelastometry (ROTEM) is a viscoelastic haemostatic assay.

Purpose of the Study:

• To investigate the predictive value of ROTEM for bleeding and thrombotic events in patients with liver cirrhosis.
• To assess the association between ROTEM parameters and clinical outcomes.

Main Methods:

• A prospective cohort study was conducted with 162 cirrhosis patients.
• ROTEM analysis was performed on all participants.
• Patients were followed for one year to record bleeding and thrombotic events.
• Univariate and multivariate logistic regression analyses were used.

Main Results:

• Nineteen patients (11.7%) experienced bleeding events within one year.
• Reduced maximum clot firmness (MCF) in EXTEM and INTEM tests was associated with bleeding.
• Prolonged clotting time (CT) in INTEM was also linked to bleeding events.
• Only MCF in the EXTEM test (MCF_EX) independently predicted bleeding events.
• No association was found between ROTEM parameters and thrombotic events.

Conclusions:

• ROTEM, particularly MCF_EX, may be a valuable tool for predicting bleeding risk in cirrhosis.
• Further research with larger cohorts is needed to validate these findings and guide clinical application.
• ROTEM did not predict thrombotic complications in this study population.