RF 1 - WELCOME TO OUR TEG TALK: PLATELET MAPPING THROMBOELASTOGRAPHY ABNORMALITIES IN TRAUMA

Objectives: The use of Platelet Mapping Thromboelastography (TEG-PM) to evaluate trauma induced coagulopathy has become more prevalent. The objective of this study was to evaluate associations between TEG-PM values and outcomes in trauma patients, including patients with isolated TBI.

Methods: A retrospective review of adult trauma patients was conducted utilizing the American College of Surgeons National Trauma Database from Aug. 2021 – Dec. 2021. Chart review was conducted to obtain specific TEG-PM parameters. Patients were excluded if they were on anti-platelets, anticoagulation, or received blood products prior to arrival. TEG-PM values and their associations with outcomes were evaluated using generalized linear model and Cox cause-specific hazards model. Outcomes included in-hospital death, hospital length of stay (LOS), and ICU stay. Relative risk (RR) and hazard ratio (HR) and their 95% confidence intervals (CIs) are provided as measures of strength of association and precision, respectively.

Results: A total of 1066 patients (mean [SD] age=49.8[21.5], 64% male, and 37.7% Black) were included, with 151 (14%) diagnosed with isolated TBI. Results for the overall cohort are presented in Table 1. Increasing ADP inhibition was associated with increased hospital and ICU LOS while decreased MA(AA) and MA(ADP) was associated with increased hospital and ICU LOS. The TEG parameters associated with increased risk of mortality were elevated R and Lys30. In the TBI cohort, increased ADP inhibition was associated with increased ICU and hospital LOS while AA inhibition was associated with increased hospital LOS.

Conclusion: Specific TEG-PM abnormalities are associated with worse outcomes in trauma patients, including TBI patients. These results require further investigation to understand associations between traumatic injury and coagulopathy.