Table 4.
Prediction of packed red blood cells transfusion (at least 3 units) based on standard laboratory tests and ROTEM tests
| Coagulation test | Threshold | Sensitivity TPR (%) | Specificity TNR (%) | PPV (%) | NPV (%) | FPR (%) | FNR (%) | Correctly classified (%) |
|---|---|---|---|---|---|---|---|---|
| Conventional coagulation tests | ||||||||
| Quick, % | < 70 | 35.1 | 86.8 | 65.0 | 65.7 | 13.2 | 64.9 | 65.6 |
| INR, a.u.* | > 1.3 | 21.9 | 97.5 | 87.5 | 60.9 | 2.5 | 78.1 | 63.9 |
| PTT, s | > 35 | 30.6 | 85.7 | 61.1 | 62.7 | 14.3 | 69.4 | 62.4 |
| Fibrinogen, g/L | < 1.5 | 25.6 | 100 | 100 | 64.6 | 0.0 | 74.4 | 68.5 |
| Platelets, 103/mcL | < 100 | 26.3 | 82.0 | 52.6 | 59.4 | 18.0 | 73.7 | 58.0 |
| Coagulopathy#, % | 59.4 | 66.7 | 48.7 | 75.5 | 33.3 | 40.6 | 64.1 | |
| Rotational Thromboelastometry | ||||||||
| Extem | ||||||||
| CT (s) | > 80 | 30.8 | 90.6 | 70.6 | 64.0 | 9.4 | 69.2 | 65.2 |
| CFT (s) | > 159 | 40.5 | 88.2 | 71.4 | 67.2 | 11.8 | 59.5 | 68.2 |
| α Angle | < 63 | 30.4 | 96.4 | 87.5 | 62.8 | 3.6 | 69.6 | 66.7 |
| CA15 (mm) | < 45 | 35.9 | 92.5 | 77.8 | 66.2 | 7.5 | 64.1 | 68.5 |
| MCF (mm) | < 50 | 38.2 | 85.1 | 65.0 | 65.6 | 14.9 | 61.8 | 65.4 |
| Intem | ||||||||
| CT (s) | > 240 | 2.6 | 98.1 | 50.0 | 57.8 | 1.9 | 97.4 | 57.6 |
| CFT (s) | > 110 | 41.0 | 90.0 | 76.2 | 66.2 | 10.0 | 59.0 | 68.5 |
| α Angle | < 70 | 32.0 | 86.2 | 66.7 | 59.2 | 13.8 | 68.0 | 61.1 |
| CA15 (mm) | < 45 | 23.1 | 94.0 | 75.0 | 61.0 | 6.0 | 76.9 | 62.9 |
| MCF (mm) | < 50 | 17.9 | 98.0 | 87.5 | 60.5 | 2.0 | 82.1 | 62.9 |
| Fibtem | ||||||||
| CA15 (mm) | < 8 | 30.8 | 96.2 | 85.7 | 64.9 | 3.8 | 69.2 | 68.1 |
| Fibtem MCF (mm) | < 9 | 33.3 | 96.2 | 86.7 | 66.2 | 3.8 | 66.7 | 69.6 |
| Aptem | ||||||||
| CT (s) | > 80 | 16.0 | 96.4 | 80.0 | 56.3 | 3.6 | 84.0 | 58.5 |
| CFT (s) | > 159 | 32.0 | 89.3 | 72.7 | 59.5 | 10.7 | 68.0 | 62.3 |
| α Angle | < 63 | 28.0 | 92.9 | 77.8 | 59.1 | 7.1 | 72.0 | 62.3 |
| CA15 (mm) | < 45 | 39.1 | 89.3 | 75.0 | 64.1 | 10.7 | 60.9 | 66.7 |
| MCF (mm) | < 50 | 28.0 | 90.3 | 70.0 | 60.9 | 9.7 | 72.0 | 62.4 |
| Coagulopathy#, % | 78.9 | 67.1 | 38.5 | 92.5 | 32.9 | 21.6 | 69.6 | |
TPR true positive rate, TNR true negative rate, PPV positive predictive value, NPV negative predictive value, FPR false positive rate, FNR false negative rate, INR international normalized ratio, a.u. arbitrary unit, PTT partial thromboplastine time, CT coagulation time, CFT clot formation time, INR international normalized ratio, MCF maximal clot firmness
#Coagulopathy
• Using standard coagulation tests, coagulopathy was defined as one or more of the following results: Quick <70%, INR > 1.3, fibrinogen <1.5 g/L, aPTT >35 s, and platelet count <100,000/mcL
• Using ROTEM results, coagulopathy was defined as two or more of the following results: EXTEM CT > 80 s, EXTEM CFT > 159 s, EXTEM MCF < 50 mm, INTEM CT > 240 s, INTEM CFT > 110 s, INTEM MCF < 50 mm, and FIBTEM MCF < 9 mm