This prospective study aimed at investigating the influence of surgery type and perioperative sampling times on the correlations between rotational thromboelastometry (ROTEM) parameters and standard laboratory coagulation tests assessing comparable coagulation phases. Patients undergoing glioblastoma multiforme resection (GBR group, n = 60) or laparoscopic colon cancer resection (CCR group, n = 40) were prospectively included. Blood samples for ROTEM and laboratory assessments were consecutively drawn within 24-hours prior to surgery (baseline), and at 2, 24 and 48-hours after surgery. Correlations between perioperative ExTEM clotting-time (CT-exTEM) and prothrombin time (PT), and between FibTEM maximum clot firmness (MCF-fibTEM) with and plasma fibrinogen (pFB) concentration (Clauss method), were evaluated using the Spearman’s rho test. The efficiency of recommended cut-offs of CT-exTEM (>75 s) and MCF-fibTEM (<10 mm) for predicting a prolonged PT (>15 s) or a low pFB (<2 g/L), respectively, was assessed using Receiver-Operator Characteristic curves. Correlations between CT-exTEM and PT were weak in GBR (rho = 0.25 [0.12–0.38], p < .01), and very weak in CCR (rho = 0.06 [−0.12–0.27]). Those between MCF-fibTEM and pFB, were strong in both GBR (rho = 0.69 [0.61–0.76], p < .01) and CCR (rho = 0.70 [0.60–0.78], p < .01). These correlations remained largely unchanged over the studied perioperative period in both groups. Recommended CT-exTEM and MCF-fibTEM cut-offs had poor sensitivity for predicting a prolonged PT (17% [8–31]) or a low pFB (46% [32–62]), without group-related differences. Neither the type of surgery nor the perioperative sampling times had a significant influence on the correlations between ROTEM parameters and standard laboratory tests.

ClinicalTrials.gov ID: NCT02652897

这项前瞻性研究旨在调查手术类型和围手术期采样时间对旋转血栓弹力测定（ROTEM）参数与评估可比凝血阶段的标准实验室凝血试验之间的相关性的影响。接受胶质母细胞瘤多形切除术（GBR组，n  = 60）或腹腔镜结肠癌切除术（CCR组，n）的患者 = 40）被预期地包括在内。在手术前24小时（基线）以及手术后2、24和48小时连续抽取用于ROTEM和实验室评估的血样。使用Spearman's rho检验评估围手术期ExTEM凝血时间（CT-exTEM）和凝血酶原时间（PT）之间的相关性，以及FibTEM最大血凝硬度（MCF-fibTEM）与血浆纤维蛋白原（pFB）浓度之间的相关性（Clauss方法）。 。建议的CT-exTEM（> 75 s）和MCF-fibTEM（<10 mm）的临界值分别用于预测PT延长（> 15 s）或低pFB（<2 g / L）的效率使用接收器-运营商特征曲线进行评估。GBR中CT-exTEM与PT之间的相关性较弱（rho = 0.25 [0.12-0.38]，p <.01），并且CCR非常弱（rho = 0.06 [-0.12-0.27]）。MCF-fibTEM和pFB之间的那些在GBR（rho = 0.69 [0.61-0.76]，p  <.01）和CCR（rho = 0.70 [0.60-0.78]，p  <.01）中均很强。在两组的研究围手术期中，这些相关性基本上保持不变。推荐的CT-exTEM和MCF-fibTEM临界值对于预测PT延长（17％[8-31]）或pFB偏低（46％[32-62]）的敏感性较差，没有与组相关的差异。手术的类型和围手术期的采样时间都不会对ROTEM参数与标准实验室测试之间的相关性产生重大影响。

ClinicalTrials.gov ID： NCT02652897