Correlation Between Thromboelastography and Standard Coagulation Tests at a Tertiary Community Hospital

Area of Science:

• Hematology
• Clinical Coagulation
• Medical Device Technology

Background:

• Thromboelastography (TEG) provides real-time whole blood clotting assessment, contrasting with static standard coagulation tests (SCTs).
• Limited evidence exists correlating TEG values with SCT results.
• This study aimed to bridge this gap by evaluating TEG-SCT correlations and intervention appropriateness.

Purpose of the Study:

• To evaluate the correlation between thromboelastography (TEG) and standard coagulation test (SCT) values.
• To assess the appropriateness of interventions based on an institutional TEG algorithm.

Main Methods:

• A retrospective chart review of 100 adult patients admitted between July and September 2019.
• Collected TEG parameters (R-time, K-time, MA, lysis) and SCT values (PT/INR, platelets, fibrinogen, Hgb/Hct).
• Utilized Spearman's coefficient for correlation analysis (strong correlation defined as r > 0.7).

Main Results:

• No strong positive correlations (r > 0.7) were found between TEG and SCT values.
• 22% of patients received blood products, and 6% received hemostatic agents.
• 30% of TEGs showed inappropriate interventions, with 61.1% of those indicating a need for platelets based on low MA angle without administration.

Conclusions:

• Findings align with existing literature showing a lack of strong correlation between TEG and SCT.
• Highlights a need for enhanced provider and pharmacist education to improve the utilization of the institutional TEG algorithm.
• Suggests potential for optimizing transfusion strategies and hemostatic agent administration through better algorithm implementation.