DIFFERENCES BETWEEN TRADITIONAL COAGULATION ITEMS, THROMBOELASTOGRAPHY, AND SONOCLOT ANALYSIS IN EVALUATING COAGULATION FUNCTIONS IN CLINICAL BLOOD TRANSFUSION PATIENTS

Anfeng Wu^1*, Xiaoxiang Zhang², Minhong Shen³

¹Department of Blood Donation Service, Huzhou Central Blood Station, Huzhou 313000, Zhejiang Province, China - ²Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, Zhejiang Province, China - ³Department of Operation Room, Huzhou Central Hospital, Huzhou 313000,Zhejiang Province, China

Objective: To analyse differences between traditional coagulation items, thromboelastography, and Sonoclot analysis in evaluating coagulation functions in clinical blood transfusion patients. 

Methods: From January 2019 to January 2020, 85 patients who needed platelet and/or plasma transfusion in our hospital were selected as the research subjects. The fasting venous blood of the patients was collected and the levels of activated partial thromboplastin time (APTT), fibrinogen, platelet content, prothrombin time, and other conventional coagulation items were measured using an automatic coagulation analyser. Clotting factor activation time, clot formation rate, clotting rate, and maximum elastogram amplitude were measured; additionally, the clotting rate, time to peak (TP), maximum clotting marker value, and platelet function were measured using a Sonoclot Coagulation and Platelet Function Analyser. Pearson linear correlation analysis was used to analyse each factor’s correlation level. The Kappa test was used to evaluate the consistency of thromboelastography, routine coagulation, and Sonoclot approaches.

Results: Pearson linear correlation analysis showed that thromboelastography was significantly positively correlated with four routine coagulation tests and Sonoclot examination, and that routine coagulation examination was significantly positively correlated with Sonoclot examination (P<0.05). On the same day, 18 patients had bleeding, including four cases of bloody stool, six cases of hematemesis, three cases of epistaxis, three cases of skin ecchymosis, and two cases of hematuria. Pearson linear correlation analysis showed that APTT and TP were correlated with bleeding (P<0.05). Kappa test analysis showed that there was no significant consistency between thromboelastography, routine coagulation, and Sonoclot (P>0.05). 

Conclusion: Traditional coagulation items, thromboelastograms, and Sonoclot analysis parameters are significantly correlated, which can reflect the coagulation functions of patients with blood transfusion, however, the consistency of these three methods is poor, and they cannot be used interchangeably. These approaches can be widely used in clinical blood transfusion.