Early Prediction of Coagulopathy in Acquired Bleeding Disorders - Revisited Using Rotational Thromboelastometry

Introduction: Acquired bleeding disorders are a major cause of mortality, both in the developed and developing countries. An acute haemorrhage should be managed immediately with blood products, factor concentrates or anti-fibrinolytics. Investigations to detect coagulopathies typically include baseline screening tests like prothrombin time, activated partial thromboplastin time, platelet count and fibrinogen level. These tests have a long turn around time which frequently lead to a blinded approach towards blood product support leading to under or over transfusion. In contrast, rotational thromboelastometry (ROTEM) which assesses haemostasis from the start of clot formation to fibrinolysis gives earliest results within ten minutes. This study was done to establish a correlation between ROTEM parameters and standard coagulation profile in the context of acquired bleeding disorders.