Diagnostic Value of Thromboelastography (TEG) for the Diagnosis of Death in Infected Patients

Abstract

In this study, we want to investigate the clinical value of each index of thromboelastography (TEG) on the prognosis of infected patients. The clinical baseline data and TEG test results of 431 infected patients in our hospital’s emergency department between January 2018 and December 2018 were selected. And the patients were divided into death and survival groups to analyze the predictive value of each index of TEG and the joint model on the death of infected patients. In the correlation study of C-reactive protein (CRP) and procalcitonin (PCT) with each TEG parameter, CRP was positively correlated with maximum amplitude (MA, r  =  0.145, P  =  .003) and elasticity constants (E, r  =  0.098, P  =  .043), respectively. PCT was positively correlated with coagulation reaction time (R, r  =  0.124, P  =  .010) and time to MA (TMA) ( r  =  0.165, P  =  .001), respectively; PCT was negatively correlated with α-Angle ( r  =  0.124, P  =  .010) and coagulation index (CI, r  =  −0.108, P  =  .026), respectively. Multifactorial regression analysis showed that granulocytes, thrombocytes, platelet distribution width (PDW), and infection site were independent influences on infected patients’ death. Diagnostic data showed that all eight TEG indicators had good specificity for predicting death, but all had poor sensitivity; thrombodynamic potential index (TPI) had the best diagnostic value (area under the curve, AUC  =  0.609, P  =  .002). The eight-indicator modeling of TEG showed that the TEG model combined with PCT and CRP, respectively, had lower diagnostic efficacy than PCT (AUC  =  0.756, P < .001); however, TEG had better specificity (82.73%) when diagnosed independently. The granulocytes, thrombocytes, PDW, and infection site are independent influencing factors of death in infected patients. Each index of TEG has better specificity in the diagnosis of death in infected patients.