Comparative Assessment of Thromboelastography and Rotational Thromboelastometry in Trauma-Related Coagulopathy

Background Trauma-induced coagulopathy (TIC) has a crucial impact on the outcome and death rate in people suffering from trauma. This study aimed to evaluate the speed, reliability, and treatment decisions of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) use in emergency trauma cases. Methods This prospective observational study was used to investigate 60 trauma patients with suspected coagulopathy. TEG and ROTEM measured clot initiation, its formation, strength, and lysis, along with the more common lab coagulation tests (prothrombin time, activated partial thromboplastin time, and platelet counts). All tests were performed to compare blood transfusion status, fibrinogen, antifibrinolytic use, and the timing of surgery. To assess the comparisons, Student's t-test and chi-square analysis were both carried out with a significant p-value of <0.05. Results Both TEG and ROTEM effectively assessed coagulopathy. ROTEM measured results faster, with a mean time of 24 minutes, compared to TEG with a mean time of 31 minutes (p<0.001). It was found that ROTEM resulted in quicker clotting time and clot formation (both p-values were 0.01 and 0.03). Patients under ROTEM treatment were treated and operated on sooner than those in the TEG group. However, there were no significant variations found in transfusion and fibrinogen use in TEG and ROTEM groups. Conclusion Both TEG and ROTEM can give reliable information about trauma patients' coagulopathy. With ROTEM, the results were obtained rapidly, and doctors were able to make clinical decisions faster in critical care cases. Even though clot test results were slightly different, both types of assays helped with better resuscitation for each patient.