Thrombelastography and conventional coagulation test for monitoring the perioperative coagulation state after joint arthroplasty

doi:10.3969/j.issn.2095-4344.2015.48.001

Abstract

Abstract:

BACKGROUND: There is a general consensus that patients undergoing joint arthroplasty surgery will be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty.
OBJECTIVE: To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.

METHODS: A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively collected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count.
RESULTS AND CONCLUSION: In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647); Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362); Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488); Aggregates formation rate (α angle) and fibrinogen had moderate correlation and consistency; the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time; the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%; the consistent proportion of aggregates formation rate (α angle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

CLC Number:

R318

Geng Wei, Zhang Zhi-gang, Pi Bin, Cheng Yu, Zhang Lei, Wang Xue-ming, Yu Xiu-lan, Zhou Li-yu, Wu Gui-zhong, Wang Zhi-dong, Yang Tong-qi, Xu Ming. Thrombelastography and conventional coagulation test for monitoring the perioperative coagulation state after joint arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(48): 7709-7716.

Figures/Tables 8

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