Description

Kashuk et al used rapid thromboelastography to identify hypercoagulability in a postoperative patient. The authors are from the University of Colorado in Denver.


 

Patient selection: surgical patient in the ICU

Exclusions: therapeutic anticoagulation

 

Method of assessment: rapid thromboelastrography (r-TEG)

 

Hypercoagulability was defined as clot strength (G) greater than 12.4 dynes per square cm.

 

Risk factors for thromboembolic event by multivariate analysis:

(1) elevated clot strength (G)

(2) lack of thromboprophylaxis

 

The odds of a thromboembolic event increased 25% for every 1 dyne per square cm increase in G.

 

No patients with normal coagulability had a thromboembolic event.

 

Patients who had thromboembolic events tended:

(1) to be in the ICU longer

(2) to be on the ventilator more days

(3) to have a longer hospital stay

 


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