PB1162 - Performance Comparison of Viscoelastic Hemostasis Analyzers in Patients with Coagulopathy: TEG5000 versus Microfluidic-Thrombo-Rheometry (MTR) System

Background: Viscoelastic hemostasis analyzers, such as TEG5000 and ROTEM, are commonly used for the precise identification of coagulopathy. A novel technology, the microfluidic thrombo-rheometry (MTR) system directly measures mechanical clot characteristics with significantly reduced test times (less than 10 minutes). However, MTR has limited data to ensure its diagnostic performance for bleeding in patients with coagulopathy.

Aims: This study aims to compare the diagnostic performance of the microfluidic-based MTR system with TEG5000 for the rapid diagnosis of patients with coagulopathy.

Methods: Samples collected from enrolled adult patients were analyzed using MTR, TEG5000, and conventional coagulation assays. Correlation between the two devices was assessed using conventional TEG parameters. Diagnostic performance for coagulopathy and thrombocytopenia was evaluated through AUROC.

Results: Analysis of samples from 113 patients revealed strong correlations between MTR and TEG5000 for various TEG parameters (p < 0.001): R-time (R = 0.93), K-time (R = 0.83), α-angle (R = 0.91), MA (R = 0.91), and Ly3.2 and LY30 (R = 0.96), CL4.3 and CL30 (R = 0.96). In the functional fibrinogen assay (CFF), robust correlations were observed for R-time (R = 0.95) and MA (R = 0.94). The kaolin-heparinase assay (CKH) exhibited a strong correlation for MA (R = 0.91). In detecting coagulopathy (international normalized ratio, >1.5), the R-time of CK assay for MTR and TEG5000 demonstrated excellent discrimination (AUC, 0.89 vs. 0.92; p < 0.001). Additionally, no significant difference was found between MTR-MA and TEG5000-MA in detecting thrombocytopenia (platelet count < 150 × 10^9/L, AUC, 0.79 vs. 0.81, p < 0.001).

Conclusion(s): MTR and TEG5000 exhibit similar diagnostic performances in evaluating coagulopathy and thrombocytopenia. Large-scale studies are necessary to determine the clinical utility of GTX for basic CK-, CFF-, and CKH assays. Nonetheless, the MTR system achieves a significant reduction in testing time without compromising diagnostic accuracy, presenting a promising advancement in coagulopathy diagnostics.