| TEG or ROTEM compared to clinical judgement or usual care in adults or children with bleeding |
|
Patient or population: adults or children with bleeding
Setting: majority of participants were undergoing cardiac surgery involving cardiopulmonary bypass in a high‐income hospital setting
Intervention: TEG or ROTEM
Comparison: clinical judgement or usual care |
| Outcomes |
Anticipated absolute effects* (95% CI) |
Relative effect
(95% CI) |
№ of participants
(studies) |
Quality of the evidence
(GRADE) |
Comments |
| Risk with clinical judgement or usual care |
Risk with TEG or ROTEM |
| Mortality |
Study population |
RR 0.81
(0.32 to 2.01) |
445
(4 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 41 per 1000 |
33 per 1000
(13 to 82) |
| |
| Proportion of patients receiving PRBCs |
Study population |
RR 0.85
(0.73 to 1.00) |
486
(6 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 622 per 1000 |
529 per 1000
(454 to 622) |
| |
| Proportion of patients receiving FFP |
Study population |
RR 0.38
(0.21 to 0.68) |
415
(4 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 415 per 1000 |
158 per 1000
(87 to 283) |
| |
| Proportion of patients receiving platelets |
Study population |
RR 0.59
(0.43 to 0.80) |
486
(6 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 311 per 1000 |
184 per 1000
(134 to 249) |
| |
| Rate of surgical reintervention |
Study population |
RR 0.62
(0.32 to 1.20) |
537
(5 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 77 per 1000 |
48 per 1000
(25 to 93) |
| |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; FFP: fresh frozen plasma; PRBC: pooled red blood cell; ROTEM: thromboelastometry; RR: risk ratio; TEG: thromboelastography. |
|
GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. |
