Consistency of thromboelastograph and routine coagulation testing in patients at different stages of liver disease

ZHAO Qing-ping; CHEN Yu-hao; LIN Fang; WANG Shu-ying; ZHANG Yang-li; Lü Xiao-na; LIU Jia; WANG Lu-yao

doi:10.3969/j.issn.1007-8134.2018.02.015

Abstract：Objective To study the consistency of thromboelastograph (TEG) parameters and routine coagulation parameters (PT, APTT) in patients at different stages of liver disease. Methods A total of 232 inpatients at different stages of liver disease were enrolled from the 302 Military Hospital of China from February 2016 to January 2017, including 41 patients with chronic hepatitis, 69 patients with compensatory cirrhosis, 79 patients with decompensated cirrhosis and 43 patients with chronic liver failure. TEG parameter R time and coagulation parameters (PT, APTT) were tested in all included patients and the results were compared between 2 test methods. Results Consistency analysis results showed that the kappa values of TEG R time with PT and APTT in patients with chronic hepatitis were -0.135 (P > 0.05) and 0.105 (P > 0.05), the consistent rates were 34.15% and 60.98% respectively. For patients with compensatory cirrhosis, the kappa values of TEG R time with PT and APTT were 0.175 (P<0.05) and 0.038 (P>0.05), the consistent rates were both 60.9%. For patients with decompensated cirrhosis, the kappa values of TEG R time with PT and APTT were 0.023 (P>0.05) and 0.038 (P>0.05), the consistent rate was 43.04% and 49.37%. The kappa values of TEG R time with PT and APTT in patients with chronic liver failure were both -0.049 (P>0.05), the consistent rate was both 13.95%. Conclusions Because of the difference of detection principle, the results of TEG can provide a more comprehensive basis for evaluating the coagulation factor status of patients at different stages of liver disease compared with routine coagulation testing.