Cardiothoracic & vascular anesthesia
Interpretation of Viscoelastic Hemostatic Assays in Cardiac Surgery Patients: Importance of Clinical Context
Authors' conclusion
This study demonstrates high inter- and intrarater reliability in ROTEM interpretation among trained professionals in cardiac surgery, with almost perfect agreement on abnormalities and interventions.
Study context
- Population
- Cardiac surgery patients, Amsterdam University Medical Center; Rotational thromboelastometry (ROTEM) before induction, after aortic declamping, postcoagulation correction and within 2 h of intensive care unit (ICU) admission343 ROTEM measurements
- Participants
- 90 patients
- Comparison
- Expert ROTEM interpretation vs ROTEM-guided algorithm
- Outcome
- Inter- and intrarater reliability of ROTEM interpretation among experts (Fleiss' kappa for binary decisions, SMC for multiple-choice questions)
Methodological detailssingle-centre, expert panel
- Single-centre
- Expert panel
Main finding
As reported in the abstract
Inter- and intrarater reliability
Interrater reliability for binary decisions substantial to almost perfect, except after declamping (Fleiss' kappa)
0.34
Simple matching coefficient (SMC) for type of abnormality and interventions good to excellent across all measuring moments
≥0.75
Intrarater reliability for binary questions almost perfect (ICC)
≥0.81
Further findings
| Outcome | Average SMC |
|---|---|
| Agreement of expert recommendations with ROTEM-guided algorithm | 0.70 |
- Agreement of expert recommendations with ROTEM-guided algorithm: experts frequently recommended fibrinogen and protamine over the algorithm's plasma and PCC
Original publication
Interpretation of Viscoelastic Hemostatic Assays in Cardiac Surgery Patients: Importance of Clinical Context. Anesth Analg. Published 19 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →