Correlation of thromboelastography with conventional coagulation testing in elderly trauma patients on pre-existing blood thinning medications

Background: Thromboelastography (TEG) may have a role in managing injured patients on pre-existing anticoagulant/antiplatelet agents. Methods: This was a prospective observational study involving elderly trauma patients who were on preexisting anticoagulant/antiplatelet agents. The correlation between conventional coagulation tests (CCTs), platelet function analysis (PFA) and TEG values was examined. The sensitivity and specificity of these tests in identifying hemorrhage progression were calculated. Results: 109 patients were included. INR and PTT correlated positively with TEG Reaction-time (r = 0.377, p < 0.001, r = 0.552, p < 0.001, respectively). The correlations of both TEG maximum amplitude and ccangle with PFA were equal (r = -0.3, p = 0.05). TEG had a higher specificity (86.1%) in identifying hemorrhage progression compared with CCTs (72.8%) and PFA (59.6%) but this relationship was not statistically significant. Conclusions: TEG correlates positively with INR and PTT and has greater, but non-significant, specificity in identifying hemorrhage progression as compared to CCTs/PFA.