Can Thrombelastography Predict Venous Thromboembolic Events in Patients With Severe Extremity Trauma?

Gary, Joshua L.; Schneider, Prism; Galpin, Matthew; Radwan, Zayde A.; Munz, John W.; Achor, Timothy S.; Prasarn, Mark L.; Cotton, Bryan A.

doi:10.1097/bot.0000000000000523

Cited by 43 publications

(58 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…87 Postoperative patients with and without cancer in the intensive care unit have been found to be at risk for venous thromboembolism and this risk can be predicted by ROTEM and TEG. 23,34 Specifically, the MA value of TEG has been found to be predictive of increased risk of deep vein thrombosis and pulmonary embolism in patients with major orthopedic trauma. 34 In patients with malignancy, both TEG and ROTEM parameters can predict hypercoagulable states.…”

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

“…23,34 Specifically, the MA value of TEG has been found to be predictive of increased risk of deep vein thrombosis and pulmonary embolism in patients with major orthopedic trauma. 34 In patients with malignancy, both TEG and ROTEM parameters can predict hypercoagulable states. Specifically in patients with malignancy, TEG parameters have shown decreased R and K, and increased MA.…”

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

“…26,75,94,95 Recently, in an attempt to further categorize the hemostatic competence of critically ill patients, VETs have been proposed as an adjunctive point-of-care methodology to further delineate the hypercoagulable states of these patients. 25,34,87,[96][97][98][99][100][101][102] The first studies of VETs in critically ill patients were performed by Starzl's liver transplantation group in Colorado in the 1960s. They first identified hyperfibrinolysis during the anhepatic phase of liver transplantation and began using routine epsilon aminocaproic acid (EACA) to treat hyperfibrinolysis.…”

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

“…102,[121][122][123][124] And, TEG-identified hypercoagulability has been used in major orthopedic trauma injuries to predict venous thromboemboli during hospitalization. 34…”

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

“…[23][24][25][26][27][28][29] The use of VETs to guide hemostatic resuscitation of patients with trauma-induced coagulopathy (TIC) has also led to these point-of-care tests being used as predictors of thromboembolism and multiorgan failure (MOF) in trauma patients during the postresuscitation period. [30][31][32][33][34] The utility of these assays has now been extended to surgical oncology patients with colon, rectal, and breast cancer who present with seemingly normal fibrinogen and platelets. 35 High rates of thrombotic complications are observed with advanced pancreatic cancer and VETs have been able to accurately predict which patients will develop postoperative pulmonary emboli after pancreatic resection.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Use of Viscoelastography in Malignancy-Associated Coagulopathy and Thrombosis: A Review

Walsh

Moore

et al. 2019

Semin Thromb Hemost

View full text Add to dashboard Cite

The relationship between malignancy and coagulopathy is one that is well documented yet incompletely understood. Clinicians have attempted to quantify the hypercoagulable state produced in various malignancies using common coagulation tests such as prothrombin time, activated partial thromboplastin time, and platelet count; however, due to these tests' focus on individual aspects of coagulation during one specific time point, they have failed to provide clinicians the complete picture of malignancy-associated coagulopathy (MAC). Viscoelastic tests (VETs), such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), are whole blood analyses that have the advantage of providing information related to the cumulative effects of plasma clotting factors, platelets, leukocytes, and red cells during all stages of the coagulation and fibrinolytic processes. VETs have gained popularity in the care of trauma patients to objectively measure trauma-induced coagulopathy (TIC), but the utility of VETs remains yet unrealized in many other medical specialties. The authors discuss the similarities and differences between TIC and MAC, and propose a mechanism for the hypercoagulable state of MAC that revolves around the thrombomodulin–thrombin complex as it switches between activating the protein C anticoagulation pathway or the thrombin activatable fibrinolysis inhibitor coagulation pathway. Additionally, they review the current literature on the use of TEG and ROTEM in patients with various malignancies. Although limited research is currently available, early results demonstrate the utility of both TEG and ROTEM in the prediction of hypercoagulable states and thromboembolic complications in oncologic patients.

show abstract

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

“…102,[121][122][123][124] And, TEG-identified hypercoagulability has been used in major orthopedic trauma injuries to predict venous thromboemboli during hospitalization. 34…”

Section: Efficacy Of Vets To Define the Hypercoagulable State In Patimentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Use of Viscoelastography in Malignancy-Associated Coagulopathy and Thrombosis: A Review

Walsh

Moore

et al. 2019

Semin Thromb Hemost

View full text Add to dashboard Cite

show abstract

Venous thromboembolism rates in patients with bone and soft tissue sarcoma of the extremities following surgical resection: A systematic review

Krzyzaniak

You

Mosca

et al. 2021

Journal of Surgical Oncology

Self Cite

View full text Add to dashboard Cite

Background: Patients undergoing an orthopedic surgery for bone or soft tissue sarcoma are at increased venous thromboembolism (VTE) risk. Unfortunately, there is a lack of thromboprophylaxis guidelines in this population. The purpose of this systematic review was to determine the soft tissue and bone sarcoma VTE rate and to explore the thromboprophylaxis regimens used.Methods: The databases MEDLINE, EMBASE, and CENTRAL were queried using keywords related to VTE and long bone malignancy requiring surgical intervention to 2020. Included studied reported VTE rate in patients with surgically managed extremity sarcoma. Descriptive statistics and weighted mean totals were calculated.Results: A total of 2082 studies were screened and 23 studies were included. The overall VTE rate was 2.9%, with a rate of 3.7% and 1.4% in patients with bone and soft tissue sarcomas, respectively. Low-molecular-weight heparin was the most commonly used chemoprophylaxis.Conclusions: There is a high VTE rate following sarcoma surgery. The VTE rate is higher in bone sarcoma surgery, which may be attributed to differences in surgery and postoperative recovery. There was no consensus on the duration or type of thromboprophylaxis used. Future research is needed to determine the most effective thromboprophylaxis regimen in patients with sarcoma and whether individualized thromboprophylaxis is required.

show abstract

Tourniquet use in primary total knee arthroplasty is associated with a hypercoagulable status: a prospective thromboelastography trial

Huang

Pan

Zheng

et al. 2021

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Can Thrombelastography Predict Venous Thromboembolic Events in Patients With Severe Extremity Trauma?

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 43 publications

References 21 publications

Use of Viscoelastography in Malignancy-Associated Coagulopathy and Thrombosis: A Review

Use of Viscoelastography in Malignancy-Associated Coagulopathy and Thrombosis: A Review

Venous thromboembolism rates in patients with bone and soft tissue sarcoma of the extremities following surgical resection: A systematic review

Tourniquet use in primary total knee arthroplasty is associated with a hypercoagulable status: a prospective thromboelastography trial

Contact Info

Product

Resources

About