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The Predictive Value of the Rotational Thromboelastometry for Bleeding Risk in Patients With Child-Pugh Class C
My Kieu Tran Thi1,2, Trang Phan Thi Thuy1,2, Dung Nguyen Viet3
1Department of Hematology, Hanoi Medical University, Hanoi, Vietnam.
Summary
Rotational Thromboelastometry (ROTEM) effectively predicts bleeding risk in advanced cirrhosis patients. Maximum clot firmness (MCF) EXTEM values can identify individuals with a lower likelihood of bleeding complications.
Area of Science:
- Hepatology
- Hematology
- Clinical Coagulation
Background:
- Patients with cirrhosis have imbalanced hemostasis, increasing bleeding and clotting risks.
- Traditional coagulation tests inadequately predict bleeding in advanced cirrhosis.
- Rotational Thromboelastometry (ROTEM) may offer a more comprehensive hemostasis assessment.
Purpose of the Study:
- To evaluate the predictive value of ROTEM for bleeding risk in decompensated cirrhosis (Child-Pugh class C).
- To compare ROTEM parameters with bleeding incidence in this patient cohort.
Main Methods:
- Retrospective analysis of 124 Child-Pugh class C cirrhosis patients.
- ROTEM analysis including INTEM, EXTEM, and FIBTEM parameters.
- Univariate and multivariate logistic regression to correlate ROTEM results with bleeding events.
Main Results:
- ROTEM clot amplitude parameters (A5, MCF) differed significantly between patients with and without bleeding (p < 0.05).
- Clotting time parameters did not show significant differences.
- Multivariate analysis identified MCF EXTEM > 45 mm as an independent predictor of lower bleeding risk.
Conclusions:
- ROTEM parameters, particularly MCF EXTEM, are valuable in assessing bleeding risk in Child-Pugh class C cirrhosis.
- Viscoelastic testing with ROTEM aids in identifying patients at low risk of bleeding.
- ROTEM provides a superior hemostasis evaluation compared to conventional coagulation tests.
