Rotational thromboelastometry values across age groups in all trauma patients presenting to a level 1 trauma centre: An observational study

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Simpson, Jack
McCullough, James
Walters, Kerin
Wake, Elizabeth
Ho, Debbie
Chan, Erick
Campbell, Don
Winearls, James
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2023
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Abstract

Objectives: To describe rotational thromboelastometry (ROTEM) values (FIBTEM A5, EXTEM A5 and EXTEM CT) across age groups and assess for a statistical trend; and to determine whether any trend in ROTEM values is affected by severity of injury and packed red blood cells (PRBC) requirement. Methods: Retrospective observational study at a level 1 trauma centre in Queensland, Australia. A total of 1601 consecutive trauma patients presenting to the ED. ROTEM data described included FIBTEM A5, EXTEM A5 and EXTEM CT. These values are described by age group (≤30 years, 31–45 years, 46–60 years, 61–75 years and >75 years), Injury Severity Score (ISS) category (<12, ≥12, <25 and ≥25) and number of PRBCs transfused in the first 24 h of admission (0 units, 1–4 units, 5–9 units and ≥10 units). Results: The median age of participants was 37 years (interquartile range [IQR] 25–54 years), with 48.2% of patients had severe trauma (ISS >12) and 13.2% receiving at least one unit of PRBC in the first 24 h of admission. Median (IQR) values for FIBTEM A5, EXTEM A5 and EXTEM CT were 13 mm (10–16 mm), 45 mm (40–49 mm) and 62 s (56–71 s), respectively. A test for trend over progressive age groups showed an increase in FIBTEM A5 (P < 0.001) and EXTEM A5 values (P < 0.001) and a decrease in EXTEM CT values (P < 0.001). Conclusion: The present study demonstrated a pattern of increasing coagulability, as defined by ROTEM, with increasing age group in trauma patients, even among the severely injured. Further investigation is required to determine the clinical impact of these findings on both the ROTEM-guided management and longitudinal outcomes of these patients and whether an age-specific approach is beneficial.

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Emergency Medicine Australasia

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This publication has been entered in Griffith Research Online as an advanced online version.

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Emergency medicine

Clinical sciences

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Life Sciences & Biomedicine

age

geriatric

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Simpson, J; McCullough, J; Walters, K; Wake, E; Ho, D; Chan, E; Campbell, D; Winearls, J, Rotational thromboelastometry values across age groups in all trauma patients presenting to a level 1 trauma centre: An observational study, Emergency Medicine Australasia, 2023

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