# Correlation Between Thromboelastography and Standard Coagulation Tests at a Tertiary Community Hospital

## TL;DR

This study examines the relationship between thromboelastography and standard coagulation tests in hospitalized patients and finds limited correlation.

## Contribution

The study evaluates an institution-specific TEG algorithm and identifies gaps in appropriate intervention use.

## Key findings

- No strong positive correlations were found between TEG and SCT values.
- 30% of TEG results indicated inappropriate interventions, often suggesting platelet use without administration.
- Provider education is needed to improve adherence to the TEG algorithm.

## Abstract

Introduction: Thromboelastography (TEG) assesses the clotting capacity of whole blood in real time, while standard coagulation tests (SCTs) represent static measures. Evidence of correlation between values obtained via TEG and SCTs remains scarce. The purpose of this study was to evaluate the correlation between TEG and SCT values and assess interventions received utilizing an institution-specific TEG algorithm.

Materials and methods: This was a single-center retrospective chart review. Data were obtained using the TEG Manager® program and the EPIC® electronic medical record for adult patients ≥18 years admitted between July 2019 and September 2019. TEG values assessed included R-time, K-time, maximum amplitude (MA), and lysis at 30 minutes. SCT values assessed included PT/INR (prothrombin time/international normalized ratio), platelet count, fibrinogen, and hemoglobin/hematocrit. Descriptive statistics were used for the primary analysis. Spearman's coefficient was used for correlation analysis, with strong correlation defined as r>0.7.

Results: The primary analysis included 100 patients, with a median age of 62.5 years (IQR 49.3-76.0) and 52% male. No strong positive correlations were identified between any TEG and SCT values. Twenty-two patients (22%) received a blood product, and six patients (6%) received a hemostatic agent, with the majority receiving platelets or four-factor prothrombin complex concentrate. An inappropriate intervention was identified in 30% of TEGs, of which 22 (61.1%) indicated a need for platelets due to a low MA angle without subsequent platelet administration.

Conclusions: The lack of strong positive correlations between TEG and SCT values was consistent with the existing literature. Further provider and pharmacist education is required to improve utilization of the institutional TEG algorithm.