PREOPERATIVE THROMBOELASTOGRAPHIC PROFILE OF PATIENTS WITH TUBERCULOUS EMPYEMA: A RETROSPECTIVE COHORT STUDY

Shan Jiang*, Yang Sun**, Zhengnian Ding***, #

*Nanjing Medical University, Nanjing, Jiangsu Province, China - **Department of Anesthesiology, Nanjing Chest Hospital, Nanjing, Jiangsu Province, 210029, China - ***Department of Anesthesiology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China

Background: Good perioperative coagulation management can reduce surgery-related bleeding. We aim to describe the characteristics of preoperative thromboelastogram (TEG) in patients with tuberculous empyema and its correlation with the results of conventional coagulation testing (CCT).

Methods: A total of 57 patients with tuberculous empyema (TE group) and 42 patients with non-tuberculous empyema (NTE group) were retrospectively reviewed. CCT and TEG were performed in all patients before surgery.

Results: There was no significant difference in preoperative general condition and CCT results between the two groups. Blood loss was greater in the TE group than in the NTE group (P < 0.05). The R and K values of TEG were longer in the TE group than in the NTE group (P<0.01 for both). The α angle was smaller in the TE group than in the NTE group (P<0.01). Linear regression analysis showed that the partial prothrombin time was positively correlated with the α angle (P<0.05), while preoperative platelet count and fibrinogen were positively correlated with the maximum amplitude (P<0.01). The K value in TEG was negatively correlated with the α angle (P<0.01). Multivariate logistic regression analysis suggested that a low platelet count (P<0.05) and α angle (P<0.05) in the TE group could be used as risk factors for increased blood loss.

Conclusion: Compared to preoperative CCT, preoperative TEG was better at predicting hypocoagulation, which might be one of the main factors causing intraoperative blood loss in patients with tuberculous empyema.