The role of thromboelastogram (TEG) and routine coagulation indexes in evaluating the severity of acute pancreatitis in the early stage of onset

Abstract

To study the role of thromboelastogram (TEG) and routine coagulation indexes in evaluating the severity of acute pancreatitis (AP) in the early stage of onset. A total of 123 patients with acute pancreatitis treated at our hospital from January 2018 to January 2021 were divided into three groups according to their disease severity. We analyzed the correlation and prognostic significance of TEG, routine coagulation indexes and blood platelet (PLT) count with disease severity. The clot reaction time (R-value), clot generation time (K-value), maximum width value (MA-value) and clot generation rate (α-angle) between the three groups were significantly different (p < 0.05). The level of prothrombin time (PT), D-dimer (D-D) and fibrinogen (FIB) and PLT count of the mild group were significantly different from the moderate and severe group as well as between the moderate and severe group (p < 0.05). Spearman correlation analysis showed that α-angle, MA-value, PT, D-D, activated partial thromboplastin time (APTT) and FIB were positively correlated, while platelet count, R-value and K-value were negatively correlated with the severity of AP. According to the follow-up results, 110 patients were divided into the survival (n = 95) or the death (n = 15) group. The R- and K-values in the survival group were significantly higher than those in the death group, while the α angle, MA-value, PT, APTT, D-D and FIB in the death group were significantly lower than those in the death group (p < 0.05). The severity and prognosis of patients with AP were directly related to the degree of coagulation disorder, and TEG combined with routine coagulation indexes demonstrated high evaluation significance for determining the severity and prognosis of AP patients.