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Verfasst von:Seeßle, Jessica [VerfasserIn]   i
 Beckmann-Löhr, Jan [VerfasserIn]   i
 Kirchner, Marietta [VerfasserIn]   i
 Michaelis, Josefin [VerfasserIn]   i
 Merle, Uta [VerfasserIn]   i
Titel:Rotational thrombelastometry (ROTEM) improves hemostasis assessment compared to conventional coagulation test in ACLF and Non-ACLF patients
Verf.angabe:Jessica Seeßle, Jan Löhr, Marietta Kirchner, Josefin Michaelis and Uta Merle
E-Jahr:2020
Jahr:17 August 2020
Umfang:13 S.
Fussnoten:Gesehen am 24.09.2020
Titel Quelle:Enthalten in: BMC gastroenterology
Ort Quelle:London : BioMed Central, 2001
Jahr Quelle:2020
Band/Heft Quelle:20(2020) Artikel-Nummer 271, 13 Seiten
ISSN Quelle:1471-230X
Abstract:Background: Patients with liver cirrhosis typically exhibit abnormal coagulation parameters in conventional coagulation tests (CCTs). Rotational thromboelastometry (ROTEM) is a holistic blood coagulation assay. This method provides an insight into the global hemostatic capabilities and has been suggested to provide a better overview of the coagulation system in liver cirrhosis. Methods: The goal of this study was to examine hemostasis in patients with stable liver cirrhosis (Non-ACLF) and in acute-on-chronic liver failure (ACLF) by CCT and ROTEM including agreement of both tests and the prospective assessment of test performance based on clinical outcomes in ACLF patients. Therefore, ACLF patients were additionally subgrouped by bleeding events. Fifty-five Non-ACLF patients and twenty-two patients with ACLF were analysed in this prospective cohort study. Results: Coagulation parameters analysed by CCT were outside the normal range in Non-ACLF and ACLF patients, but were significantly more aberrant in ACLF patients. Non-ACLF patients analysed by ROTEM revealed parameters largely within the normal limits, while significantly more ROTEM parameters in ACLF patients were affected. Maximum clot firmness (MCF) was significantly divergent between both patient groups and correlated well with levels of fibrinogen and platelet count. Using Cohen’s Kappa coefficient κ, the strength of agreement between CCT and ROTEM analyses was determined to be fair for Non-ACLF patients and moderate for ACLF patients. Bleeding events occurred significantly more often in ACLF group with significantly reduced A10 and MCF. Conclusions: For assessing hemostasis in Non-ACLF and ACLF patients the underlying dataset shows advantages of ROTEM over CCT. A10 and MCF represent suitable prognostic parameters in predicting bleeding events in ACLF group.
DOI:doi:10.1186/s12876-020-01413-w
URL:kostenfrei: Volltext: https://doi.org/10.1186/s12876-020-01413-w
 DOI: https://doi.org/10.1186/s12876-020-01413-w
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1733701516
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