Prognostic Value of Thromboelastography Parameters for Early Trauma-Induced Coagulopathy in Severely Injured Patients: A Retrospective Cohort Study

Background and importance: Early trauma-induced coagulopathy (eTIC) is a major contributor to hemorrhage-related mortality after severe trauma. Viscoelastic testing using thromboelastography (TEG) has been increasingly implemented in trauma resuscitation; however, its prognostic value compared with conventional coagulation testing remains uncertain.

Objectives

We evaluated the ability of TEG parameters to detect eTIC, hypofibrinogenemia, and hyperfibrinolysis in severely injured trauma patients. In addition, we assessed their prognostic performance for transfusion requirements and mortality compared with conventional laboratory parameters.

Design

Retrospective single-center cohort study. Settings and participants: Severely injured adult trauma patients admitted to the resuscitation room of a Level I trauma center, between January 2019 and October 2024 were screened. Outcome measures and analysis: Primary outcomes were detection of eTIC (INR > 1.2), severe coagulopathy (INR > 1.5), hypofibrinogenemia (< 200 mg/dL), and thrombocytopenia (< 100,000/μL). Secondary outcomes included the ability of coagulation parameters to predict the need for transfusion of ≥ 5 units of packed red blood cells within the first 24 h after admission and in-hospital mortality.