Perioperative medicine & outcomes
A Retrospective Analysis of Thromboelastometry and Conventional Laboratory Values in Nonsurgical and Noncardiac Surgery Patients: Not What One Might Expect From Cardiac Surgery Data
Authors' conclusion
FIBTEM A10 (fibrinogen) and EXTEM/INTEM A10 (platelets) correlate well with conventional laboratory measures in a heterogenous noncardiac cohort, supporting thromboelastometry as a point-of-care tool. However, the cardiac-derived predictive model shows substantial bias and variability, precluding reliable patient-level estimates.
Study context
- Population
- Nonsurgical and noncardiac surgery patients with simultaneous thromboelastometry and laboratory measurements
- Participants
- 257 participants
- Exposure
- Thromboelastometry parameters vs conventional laboratory tests; cardiac surgery-derived predictive app
- Outcome
- Correlation of thromboelastometry with conventional laboratory tests
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Fibrinogen vs FIBTEM A10 and FIBTEM MCF, Pearson r
0.82
Platelet count vs EXTEM A10, Pearson r
0.58
Platelet count vs INTEM A10, Pearson r
0.61
Platelet count vs EXTEM-FIBTEM A10, Pearson r
0.57
Observational data: associations, not effects.
Further findings
Diagnostic performance for hypofibrinogenemia (≤1.5 g/L), AUROC
- FIBTEM A10
- 0.92
- FIBTEM MCF
- 0.89
- EXTEM alpha
- 0.89
Diagnostic performance for thrombocytopenia (≤100 × 10⁹/L), AUROC
- EXTEM A10
- 0.95
- INTEM A10
- 0.96
- EXTEM-FIBTEM A10
- 0.97
Cardiac surgery-derived predictive app: predicted vs observed values
- Correlation for fibrinogen, r
- 0.82
- Correlation for platelets, r
- 0.58 to 0.61
- Bland-Altman bias for fibrinogen (systematic underestimation by the app, wide limits of agreement)
- +0.8 g/L
- Bland-Altman bias for platelets
- +62, +50, and +50 × 10⁹/L
Original publication
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