Correlation of plasma coagulation tests and fibrinogen Clauss with rotational thromboelastometry parameters and prediction of bleeding in dogs

Abstract

BACKGROUND: Correlation of plasma fibrinogen concentration (fibrinogenClauss ) with rotational thromboelastometry (ROTEM) parameters has not been investigated in dogs.
OBJECTIVES: To determine the correlation between plasma coagulation tests and fibrinogenClauss with ROTEM parameters and to evaluate their ability to predict bleeding in dogs.
ANIMALS: Ninety-seven dogs with concurrent determination of fibrinogenClauss and fibrin polymerization test (FIBTEM) analysis.
METHODS: Signalment, pretreatment, clinical signs of bleeding, fibrinogenClauss , plasma coagulation test results, hematocrit, platelet count, FIBTEM, extrinsic (EXTEM) and intrinsic (INTEM) activated ROTEM assays were retrieved retrospectively. Correlations between fibrinogenClauss and FIBTEM maximum clot firmness (MCFFIBTEM ) and between prothrombin time (PT) or activated partial thromboplastin time (aPTT) and ROTEM parameters were determined. Dogs were further assigned to groups with or without clinical signs of bleeding. The prognostic significance of significantly different parameters to predict bleeding was evaluated.
RESULTS: FibrinogenClauss showed strong correlation with MCFFIBTEM (r = 0.860, n = 97, P < .001). PT showed strong correlation with EXTEM clotting time (CTEXTEM ) (r = 0.839, n = 53, P < .001), and aPTT was strongly correlated with INTEM CT (CTINTEM ) (r = 0.664, n = 31, P < .001). Platelet count, PT/aPTT, EXTEM clot formation time (CFTEXTEM ), MCFEXTEM , EXTEM maximum clot elasticity (MCEEXTEM ), and CTINTEM were significantly different between groups. A CTINTEM >149 seconds was 100% sensitive to detect bleeding.
CONCLUSIONS AND CLINICAL IMPORTANCE: The MCFFIBTEM can be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibrinogenClauss . In addition, CTEXTEM and CTINTEM are strongly correlated with PT and aPTT, respectively.