Thromboelastography parameters predict hematoma enlargement in patients with intracerebral hemorrhage
10.3760/cma.j.issn.1673-4165.2018.12.005
- VernacularTitle:血栓弹力图参数预测脑出血患者血肿增大
- Author:
Yiqi LU
1
;
Jianzhong XUE
;
Jiangang HUANG
;
Hui LIU
;
Xiaoyi ZHANG
Author Information
1. 215500,常熟市第二人民医院神经内科
- Keywords:
Cerebral Hemorrhage;
Thrombelastography;
Blood Coagulation Disorders;
Disease Progression;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2018;26(12):902-907
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of thromboelastography (TEG) parameters for hematoma enlargement after intracerebral hemorrhage.Methods Patients with primary intracerebral hemorrhage within 6 h after onset admitted to the Second People's Hospital of Changshu between March 2016 and March 2018 were enrolled prospectively.Hematoma enlargement was defined as the volume of hematoma detected by CT within 48 h after onset increased by ＞ 12.5 cm3 or ＞ 33％ compared with that at admission.The baseline data in the hematoma enlargement group and the non-hematoma enlargement group were compared.Multiple logistic regression analysis was used to determine the independent correlation between TEG parameters and hematoma enlargement.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of TEG parameters for hematoma enlargement.Results A total of 141 patients with intracerebral hemorrhage were enrolled,of which 38 (27.0％) had hematoma enlargement.Compared with the non-hematoma enlargement group,the baseline National Institutes of Health Stroke Scale score (P =0.001),thrombin time (P =0.022),fasting blood glucose (P =0.007),hematoma ruptured into the ventricle (P =0.001),baseline hematoma volume (P =0.001),and coagulation reaction time measured by TEG (P=0.002) were significantly increased in the hematoma enlargement group,while the baseline Glasgow Coma Scale score (P =0.001) and α angle measured by TEG (P =0.021) were significantly decreased.Multivariate logistic regression analysis showed that after adjusting confounding factors,the prolonged coagulation reaction time (odds ratio [OR] 3.436,95％ confidence interval [CI] 1.083-9.905;P =0.036) and decreased α angle (OR 0.777,95％ CI0.656-0.921;P =0.004) were the independent predictors of hematoma enlargement after intracerebral hemorrhage.The area under the curve of coagulation reaction time predicting hematoma enlargement was 0.680 (95％ CI 0.588-0.772;P =0.004),and the sensitivity and specificity were 84.2％ and 52.4％ when 4.0 min was the cut-off value.The area under the curve of α angle predicting hematoma enlargement was 0.636 (95％ CI 0.534-0.738;P =0.007).The sensitivity and specificity were 73.7％ and 57.3％ when the cut-off value was 65.1 °.Conclusion The prolonged coagulation reaction time and the decrease of α angle detected by TEG had certain predictive value for hematoma enlargement after cerebral hemorrhage.
