Kashuk et al used rapid thromboelastography to identify hypercoagulability in a postoperative patient. The authors are from the University of Colorado in Denver.


Patient selection: surgical patient in the ICU

Exclusions: therapeutic anticoagulation


Method of assessment: rapid thromboelastrography (r-TEG)


Hypercoagulability was defined as clot strength (G) greater than 12.4 dynes per square cm.


Risk factors for thromboembolic event by multivariate analysis:

(1) elevated clot strength (G)

(2) lack of thromboprophylaxis


The odds of a thromboembolic event increased 25% for every 1 dyne per square cm increase in G.


No patients with normal coagulability had a thromboembolic event.


Patients who had thromboembolic events tended:

(1) to be in the ICU longer

(2) to be on the ventilator more days

(3) to have a longer hospital stay


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