Subacute Thromboelastographic Clot Strength and Discharge Functional Status After Acute Ischemic Stroke

Thromboelastography (TEG) characterizes whole-blood clot kinetics and strength at a single time point. We examined the concurrent association of early subacute TEG parameters with functional status at discharge after acute ischemic stroke. TEG was performed 5–7 days after admission, and the analyses included 372 patients with acute ischemic stroke. Because the TEG 5000 and TEG 6s are not directly interchangeable, each parameter was standardized within platform. The primary outcome was discharge modified Rankin Scale (mRS) 3-6. In multivariable models (N=356; 106 events), each platform-specific 1-SD increase in alpha angle was associated with poor discharge status (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.03-2.04; p=0.032), as was MA (adjusted OR, 1.84; 95% CI, 1.32-2.59; p<0.001). The MA association persisted within both platforms and after adjustment for discharge antiplatelet and anticoagulant prescriptions. Associations with 3-month functional status were not statistically significant, although the estimates remained in the same direction. Higher alpha angle and MA measured 5–7 days after admission were associated with poor functional status at discharge, particularly for MA, suggesting that these TEG parameters may reflect an in-hospital hemostatic state related to short-term functional status.