title: Comparison of point-of-care hemostatic assays, routine coagulation tests, and outcome scores in critically ill patients.
abstract: OBJECTIVE
  The purposes of the study are to compare point-of-care (POC) hemostatic devices in critically ill patients with routine laboratory tests and intensive care unit (ICU) outcome scoring assessments and to describe the time course of these variables in relation to mortality rate.
  
  
  METHODS
  Patients admitted to the ICU with a prognosis of more than 3 days of stay were included. The POC devices, Multiplate platelet aggregometry, rotational thromboelastometry, and ReoRox viscoelastic tests, were used. All variables were compared between survivors and nonsurvivors. Point-of-care results were compared to prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen concentration, and Sequential Organ Failure Assessment score and Simplified Acute Physiology Score 3.
  
  
  RESULTS
  Blood was sampled on days 0 to 1, 2 to 3, and 4 to 10 from 114 patients with mixed diagnoses during 237 sampling events. Nonsurvivors showed POC and laboratory signs of hypocoagulation and decreased fibrinolysis over time compared to survivors. ReoRox detected differences between survivors and nonsurvivors better than ROTEM and Multiplate.
  
  
  CONCLUSIONS
  All POC and routine laboratory tests showed a hypocoagulative response in nonsurvivors compared to survivors. ReoRox was better than ROTEM and Multiplate at detecting differences between surviving and nonsurviving ICU patients. However, Simplified Acute Physiology Score 3 showed the best association to mortality outcome.
authors.affiliation: Medical Faculty, University of Lund, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Larsson
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: N
authors.initials: N
authors.lastname: Tynngård
authors.affiliation: Medical Faculty, University of Lund, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital Lund, 22185 Lund, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Kander
authors.affiliation: Medical Faculty, University of Lund, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital Lund, 22185 Lund, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Bonnevier
authors.affiliation: Medical Faculty, University of Lund, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital Lund, 22185 Lund, Sweden. Electronic address: ulf.schott@skane.se.
authors.forename: U
authors.initials: U
authors.lastname: Schött
mesh_terms: D000368:Aged; D001777:Blood Coagulation / Q000502:physiology; D001778:Blood Coagulation Disorders / Q000097:blood*; D001780:Blood Coagulation Tests / Q000379:methods; D001792:Blood Platelets / Q000502:physiology; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D005340:Fibrinogen; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D063305:Organ Dysfunction Scores; D010314:Partial Thromboplastin Time; D010976:Platelet Count / Q000379:methods; D019095:Point-of-Care Systems; D011379:Prognosis; D011446:Prospective Studies; D013916:Thrombelastography / Q000379:methods
chemical_list: D005340:Fibrinogen
keywords: Aggregation; Coagulopathy; Platelets; Survival; Thromboelastography