Article Figures & Data
- Figure 1
Rotational thromboelastography (ROTEM) and thromboembolic event timeline.
- Figure 2
(A and B) CTEX and IN and (C and D) CFTEX and IN for patients with and without coagulopathic complications. Outliers are represented by a circle (mild outlier) or an asterisk (severe outlier). CFT, clot formation time; CT, clotting time; EX, EXTEM; IN, INTEM.
- Figure 3
(A, B, and C) MCFEX, IN and FIB for patients with and without coagulopathic complications. Outliers are represented by a circle (mild outlier) or an asterisk (severe outlier). EX, EXTEM; FIB, FIBTEM; IN, INTEM; MCF, maximum clot firmness.
- Figure 4
(A and B) CTEX and IN and (C and D) CFTEX and IN for patients with and without heparin drip administration. Outliers are represented by a circle (mild outlier) or an asterisk (severe outlier). CFT, clot formation time; CT, clotting time; EX, EXTEM; IN, INTEM.
- Figure 5
(A, B, and C) MCFEX, IN and FIB for patients with and without heparin drip administration. Outliers are represented by a circle (mild outlier) or an asterisk (severe outlier). EX, EXTEM; FIB, FIBTEM; IN, INTEM; MCF, maximum clot firmness.
- Table 1
Rotational thromboelastography parameters
Clot initiation Clotting time Clot kinetics Clot formation time Clot strength Amplitude at 10 minutes
Maximum clot firmnessFibrinolysis Maximum lysis - Table 2
Patient demographics, admission vital signs, and presenting symptoms
Demographics, n (%) Age, mean (SD) 57.9 (14.4) Male 16 (76.2) BMI kg/m2, mean (SD) 32.3 (9.2) Mortality 3 (14.3) Admission vitals, mean (SD) Temperature, °F 99.6 (2.1) Pulse, beats per minute 98.6 (25.1) RR, breaths per minute 25.3 (8.8) O2 saturation (%) 91.6 (6.3) Systolic, mm Hg 132.6 (19.6) Diastolic, mm Hg 75.6 (14.9) Symptoms, n (%) Febrile 16 (76.2) Lethargy 5 (23.8) Shortness of breath 15 (71.4) Headache 1 (4.8) Anorexia 0 (0) Rhinorrhea 0 (0) Sputum 3 (14.3) Sore throat 1 (4.8) Cough 15 (71.4) Emesis 1 (4.8) Myalgia 2 (9.5) Diarrhea 3 (14.3) Recent travel 0 (0) Known sick contacts 2 (9.5) Length of symptoms, mean days (SD) 5.2 (3.1) BMI, body mass index; RR, respiratory rate.
- Table 3
Acute phase reactants and coagulation markers
Laboratory values, mean (SD) Reference range Mean (SD) Peak, mean No HC, mean (SD)
n=14HC, mean (SD)
n=7P value Prothrombin time, seconds 9.8–12.0 12.7 (1.9) 18.7 12.6 (1.6) 13.0 (2.5) 0.6 Partial thromboplastin time, seconds 25.0–32.0 36.3 (7.7) 53.3 35.5 (8.4) 38.1 (6.5) 0.5 INR 1.2 (0.2) 1.85 1.1 (0.1) 1.2 (0.3) 0.4 Platelet count, k/mm3 160–410 181.2 (56.8) 336.8 178.9 (45.6) 185.7 (78.9) 0.8 D-dimer, mg/L <0.59 10.8 (6.4) 24.7 10.9 (5.6) 10.4 (8.4) 0.8 Ferritin, µg/L 18.0–370.0 1743.1 (1568.4) 5268.9 1396.9 (1313.1) 2435.5 (1904.1) 0.1 C-reactive protein, mg/dL 0.00–0.50 13.4 (26.3) 26.8 12.7 (6.5) 14.7 (6.5) 0.5 LDH, U/L 125–220 469.6 (175.1) 874.9 440.3 (141.8) 528.2 (229.4) 0.3 Fibrinogen, mg/dL 180–400 406.3 (162.0) 732.1 360.8 (126.3) 474.5 (196.8) 0.2 HC, hypercoagulopathic complications; INR, international normalized ratio; LDH, lactate dehydrogenase.
- Table 4
Description of hypercoagulopathic complications (confirmed DVT and catheter thrombosis (≥3 episodes), stroke, and use of therapeutic anticoagulation)
Patient number DVT DVT location Clotted central venous catheters Confirmed stroke Therapeutic anticoagulation Anticoagulation use (days) HD Comorbidities 1 – – Y – Y 4 Y MG 2 – – – – – – – HLD, HTN 3 – – Y – Y 24 – HTN, DM 4 – – – – Y 6 – None 5 – – – – – – – HTN, TIA 6 – – – – – – Y HTN 7 Y Brachial vein – Y Y 6 – None 8 – – – – Y 2 – CP 9 – – – – Y 3 – DA 10 – – – – – – – CILI 11 Y Internal jugular – – Y 7 – HTN, EtOH 12 – – – – Y 23 Y HLD, PVD, SZ 13 – – – – Y 3 Y HTN, CHF 14 – – – – – – – HTN 15 – – – – Y 9 Y HTN, DM, MG 16 – – – – – – – CILI, EtOH 17 – – – Y Y 14 – ARF, HTN, DM 18 – – – – Y 15 – HTN, DM, TIA 19 – – – – Y 11 Y HTN, DM 20 – – – – Y 6 – HLD, CHF, HTN, COPD, CAD 21 – – – Y Y 2 Y HLD, HTN, DM CAD, coronary artery disease; CHF, congestive heart failure; CILI, cirrhosis of the liver; COPD, chronic obstructive pulmonary disease; CP, cerebral palsy; DA, drug abuse; DM, diabetes; DVT, deep vein thrombosis; EtOH, alcohol use; HD, hemodialysis; HLD, hyperlipidemia; HTN, hypertension; MG, myasthenia gravis; PVD, peripheral vascular disease; SZ, seizure; TIA, transient ischemic attack; Y, yes.
- Table 5
ROTEM parameters and PTT by median and mean quartile of patients with hypercoagulopathy versus patients without coagulopathy
HC (no=0, yes=1) n Reference range Minimum Q1 Median Q3 Maximum 95% median CI CTEX 0 40 43–82 49 59 71 86.7 495 64.3 to 121.2 1 21 0 64.5 80 107 311 62.6 to 115.2 CTIN 0 40 122–208 123 150.2 162.5 215 482 168.2 to 213.4 1 21 123 172.5 209 228.5 572 176.2 to 261.1 CFTEX 0 40 48–127 39 61.7 81 115 295 76.3 to 106.6 1 21 42 48 56 74.5 331 47.2 to 105.3 CFTIN 0 40 45–110 35 58.2 76 111.5 301 72.5 to 101.4 1 21 44 51 58 80.5 294 52.5 to 104.9 A10EX 0 40 40–60 30 50.2 58.5 67.7 78 54.7 to 61.4 1 21 28 57.5 64 69 74 56.1 to 66.1 A10IN 0 40 40–60 29 47.5 56 63.7 74 53.6 to 59.7 1 21 29 54.5 63 65 72 52.8 to 63.2 MCFEX 0 40 52–70 43 59.2 66 72 83 63.1 to 68.5 1 21 39 67.5 70 73.5 79 65.2 to 72.8 MCFIN 0 40 51–72 39 58.2 64 71 79 61.1 to 66.6 1 21 38 63.5 67 72 77 61.8 to 70.1 MCFFIB 0 40 7–24 5 15 23 28 40 19.8 to 25.6 1 21 7 22 32 38 41 23.8 to 33.9 PTT 0 40 25–32 (seconds) 19 26 29.3 35.5 77 29.5 to 36 1 21 25 32.7 41 48.6 63 36.8 to 46.9 A10, amplitude at 10 minutes; CFT, clot formation time; CT, clotting time; EX, EXTEM; FIB, FIBTEM; HC, hypercoagulopathic complications; IN, INTEM; MCF, maximum clot firmness; n, number of ROTEM test results; PTT, partial thromboplastin time; ROTEM, rotational thromboelastography.
- Table 6
ROTEM parameters and PTT by median and mean quartile of patients with and without therapeutic heparin administration
Heparin drip use (no=0, yes=1) n Reference range Minimum Q1 Median Q3 Maximum 95% median CI CTEX 0 18 43–82 49 57 68.5 76 89 61.3 to 74.1 1 43 0 62 79 107 495 72.9 to 129.8 CTIN 0 18 122–208 130 150.5 160 173.2 222 152.2 to 172.9 1 43 123 157 196 229 572 188.6 to 216.2 CFTEX 0 18 48–127 52 74 85 113 194 78.6 to 111.3 1 43 39 48 61 95 331 63.9 to 101.0 CFTIN 0 18 45–110 51 67.7 81 110 121 75.1 to 96.0 1 43 35 51 59 93 301 65.5 to 101.2 A10EX 0 18 40–60 41 50.7 55 59.5 70 51.4 to 58.8 1 43 28 55 63 70 78 57.3 to 64.3 A10IN 0 18 40–60 46 49.7 54.5 59.2 66 51.5 to 57.2 1 43 29 50 60 68 74 54.8 to 61.8 MCFEX 0 18 52–70 50 59.7 64.5 67.5 76 60.8 to 67.2 1 43 39 64 70 74 83 65.3 to 70.9 MCFIN 0 18 51–72 54 59.7 62.5 66.2 73 60.4 to 65.2 1 43 38 59 67 73 79 62.3 to 68.3 MCFFIB 0 18 7–24 11 12.7 18 25 37 15.6 to 22.9 1 43 5 21 29 36 41 24.1 to 30.3 PTT 0 18 25–32 (seconds) 19 25.1 27 28.7 29 25.4 to 27.9 1 43 25 32.6 35.6 48.1 77 36.3 to 43.3 A10, amplitude at 10 minutes; CFT, clot formation time; CT, clotting time; EX, EXTEM; FIB, FIBTEM; IN, INTEM; MCF, maximum clot firmness; PTT, partial thromboplastin time; ROTEM, rotational thromboelastography.
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