Study | Comparator | ROTEM® thresholds used | Accuracy of threshold Sensitivity/Specificity | ROC/AUC | Key findings | |
---|---|---|---|---|---|---|
Massive transfusion | ||||||
Leemann 2010 [38] | aPTT > 36 s PLT < 100 × 103 INR > 1.2 | EXTEM/INTEM CA10, CA20, CFT, MCF as per manufacturer | NA | NA | 0.82 | 2 – INTEM MCF 37.5 ± 2.9 associated with MT requirements within 24 h |
Tauber, 2011 [40] | FIB 1.50 g/L INR > 1.5 | FIBTEM MCF < 7 mm | 71 | NA | 0.80 | 1 – FIBTEM MCF < 7 mm associated with RBC use (OR 0.92, 95 % CI 0.87–0.98) |
Schochl 2011 [28] | PLT ≤ 161 × 103 aPTT ≤ 35.2 s FIB ≤ 1.4 g/dL | FIBTEM A10 ≤ 4 mm FIBTEM MCF ≤ 7 mm | 63.3 77.5 | 83.2 74.9 | 0.83 0.84 | 1 – 85 % patients with FIBTEM MCF 0–3 mm received MT 2 – FIBTEM A10 (0.83) and FIBTEM MCF (0.84) showed high predictive value for MT |
Davenport 2011 [41] | PTR > 1.2 | EXTEM CA5 ≤ 35 mm | 71.4 % | NA | NA | 1 – CA5 identified patients who required MT with detection rate of 71 % vs. 43 % for PTR > 1.2, p < 0.001 |
Hagemo 2015 [43] | INR > 1.2 | EXTEM CA5 ≤ 40 mm FIBTEM CA5 ≤ 9 mm | 72.7 % | 77.5 % | 0.75 0.78 | 1 – ROTEM CA5 is a valid predictor for MT. |
Any transfusion | ||||||
Schochl, 2010 [27] | PT (11–13.5 s) aPTT (26-35 s) FIB (2–4.5 g/L) PLT (150–350) | FIBTEM MCF < 10 mm EXTEM CT > 1.5× normal | NA | NA | NA | 1 – ROTEM® guided FC and PCC transfusion, associated with favorable survival (24.4 % vs. 33.7 %; p = 0.032) |
Davenport 2011 [41] | PTR > 1.2 | EXTEM CA5 ≤ 35 mm CT > 94 s Alpha < 650 | 33.3 % | NA | NA | 1 – CA5 ≤ 35 mm predicted RBC and plasma transfusion. Patients with CA5 ≤ 35 mm received more RBC (46 % vs. 17 %, p < 0.001) and plasma (37 % vs. 11 %, p < 0.001) transfusions. 2 – CA5 ≤ 35 mm received more RBC (4U vs. 1U, p < 0.001) and FFP (2U vs. 0U, p < 0.001) |