Moore et al used coagulation tests to identify trauma-related coagulopathy and the need for massive transfusion. The authors are from the University of Colorado and the Bonfils Blood Center in Denver.
Patient selection: trauma patient
Outcome: massive transfusion (> 4 units RBCs per hour or death due to hemorrhagic shock in the first 6 hours after injury)
Parameter:
(1) time to maximum amplitude (TMA) for modified thromboelastography (TEG) with addition of tissue plasminogen activator (tPA), high dose
(2) INR
INR
TMA with High Dose tPA
Percent Massive Transfusion
<= 1.1
< 16 minutes
0%
<= 1.1
>= 16 minutes
1.6%
> 1.1
< 16 minutes
49%
> 1.1
>= 16 minutes
12.3%
An INR <= 1.1 had a high negative predictive value for massive transfusion.
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