Faculty Collaboration Database

A comparison between the TEG 6s and TEG 5000 analyzers to assess coagulation in trauma patients. J Trauma Acute Care Surg 2020 Feb;88(2):279-285

Date

11/19/2019

Pubmed ID

31738314

Pubmed Central ID

PMC7004476

DOI

10.1097/TA.0000000000002545

Scopus ID

2-s2.0-85077399772 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

BACKGROUND: Trauma-induced coagulopathy is a major driver of mortality following severe injury. Viscoelastic goal-directed resuscitation can reduce mortality after injury. The TEG 5000 system is widely used for viscoelastic testing. However, the TEG 6s system incorporates newer technology, with encouraging results in cardiovascular interventions. The purpose of this study was to validate the TEG 6s system for use in trauma patients.

METHODS: Multicenter noninvasive observational study for method comparison conducted at 12 US Levels I and II trauma centers. Agreement between the TEG 6s and TEG 5000 systems was examined using citrated kaolin reaction time (CK.R), citrated functional fibrinogen maximum amplitude (CFF.MA), citrated kaolin percent clot lysis at 30 minutes (CK.LY30), citrated RapidTEG maximum amplitude (CRT.MA), and citrated kaolin maximum amplitude (CK.MA) parameters in adults meeting full or limited trauma team criteria. Blood was drawn ≤1 hour after admission. Assays were repeated in duplicate. Reliability (TEG 5000 vs. TEG 6s analyzers) and repeatability (interdevice comparison) was quantified. Linear regression was used to define the relationship between TEG 6s and TEG 5000 devices.

RESULTS: A total of 475 patients were enrolled. The cohort was predominantly male (68.6%) with a median age of 49 years. Regression line slope estimates (ß) and linear correlation estimates (p) were as follows: CK.R (ß = 1.05, ρ = 0.9), CFF.MA (ß = 0.99, ρ = 0.95), CK.LY30 (ß = 1.01, ρ = 0.91), CRT.MA (TEG 6s) versus CK.MA (TEG 5000) (ß = 1.06, ρ = 0.86) as well as versus CRT.MA (TEG 5000) (ß = 0.93, ρ = 0.93), indicating strong reliability between the devices. Overall, within-device repeatability was better for TEG 6s versus TEG 5000, particularly for CFF.MA and CK.LY30.

CONCLUSION: The TEG 6s device appears to be highly reliable for use in trauma patients, with close correlation to the TEG 5000 device and equivalent/improved within-device reliability. Given the potential advantages of using the TEG 6s device at the site of care, confirmation of agreement between the devices represents an important advance in diagnostic testing.

LEVEL OF EVIDENCE: Diagnostic test, level II.

Author List

Neal MD, Moore EE, Walsh M, Thomas S, Callcut RA, Kornblith LZ, Schreiber M, Ekeh AP, Singer AJ, Lottenberg L, Foreman M, Evans S, Winfield RD, Goodman MD, Freeman C, Milia D, Saillant N, Hartmann J, Achneck HE

Author

David J. Milia MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Blood Coagulation Disorders
Female
Humans
Male
Middle Aged
Point-of-Care Systems
Thrombelastography
Wounds and Injuries
Young Adult