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Comparison of point-of-care hemostatic assays, routine coagulation tests, and outcome scores in critically ill patients
Lund University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
Lund University, Sweden; Skåne University Hospital Lund, Sweden.
Lund University, Sweden; Skåne University Hospital Lund, Sweden.
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2015 (English)In: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 30, no 5, 1032-1038 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The purposes of the study are to compare point-of-care (POC) hemostatic devices in critically ill patients with routine laboratory tests and intensive care unit (ICU) outcome scoring assessments and to describe the time course of these variables in relation to mortality rate. Materials and methods: Patients admitted to the ICU with a prognosis of more than 3 days of stay were included. The POC devices, Multiplate platelet aggregometry, rotational thromboelastometry, and ReoRox viscoelastic tests, were used. All variables were compared between survivors and nonsurvivors. Point-of-care results were compared to prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen concentration, and Sequential Organ Failure Assessment score and Simplified Acute Physiology Score 3. Results: Blood was sampled on days 0 to 1, 2 to 3, and 4 to 10 from 114 patients with mixed diagnoses during 237 sampling events. Nonsurvivors showed POC and laboratory signs of hypocoagulation and decreased fibrinolysis over time compared to survivors. ReoRox detected differences between survivors and nonsurvivors better than ROTEM and Multiplate. Conclusions: All POC and routine laboratory tests showed a hypocoagulative response in nonsurvivors compared to survivors. ReoRox was better than ROTEM and Multiplate at detecting differences between surviving and nonsurviving ICU patients. However, Simplified Acute Physiology Score 3 showed the best association to mortality outcome.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC , 2015. Vol. 30, no 5, 1032-1038 p.
Keyword [en]
Aggregation; Coagulopathy; Platelets; Thromboelastography; Survival
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-122052DOI: 10.1016/j.jcrc.2015.06.014ISI: 000360558500029PubMedID: 26190696OAI: oai:DiVA.org:liu-122052DiVA: diva2:885453
Available from: 2015-12-18 Created: 2015-10-19 Last updated: 2016-03-23

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Tynngård, Nahreen
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Division of Microbiology and Molecular MedicineFaculty of Medicine and Health SciencesDepartment of Clinical Immunology and Transfusion MedicineDepartment of Clinical Chemistry
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