Abstract T P321: Thrombelastography Can Detect Differences In Patients With Intracerebral Hemorrhage With And Without Intraventricular Hemorrhage

Abstract

Background: Intraventricular hemorrhage (IVH) is an important variable for predicting outcomes in patients with intracerebral hemorrhage (ICH). Thrombelastography (TEG) analyzes the dynamics of coagulation (Figure 1) and has previously demonstrated a hypercoagulable state in patients with acute ischemic stroke. Less is known about TEG and patients with ICH, especially those associated with IVH. We sought to determine whether TEG can detect differences between patients with ICH with and without IVH. Methods: Venous blood of patients with spontaneous ICH was analyzed with TEG. Demographics and baseline TEG values were compared between patients with and without IVH on initial CT scan. Multivariable linear regression models were conducted to compare the differences in TEG components between the two groups after adjusting for potential confounders. Results: Sixty-nine patients with ICH (32 with IVH, 37 without IVH) were analyzed. Baseline antiplatelet use, platelet count, coagulation studies (PT/PTT), and hematoma volume were similar between the two groups. Increased R time (table 1) was seen in patients with IVH (R=4.9) compared to those without IVH (R=4.0, p=0.04), indicating increased time to clot formation. No differences were observed in other baseline TEG values. Conclusion: TEG can detect differences in the coagulation profile of ICH patients with and without IVH. ICH patients with IVH have a coagulopathy detectable by TEG independent of antiplatelet or anticoagulant use. TEG may be valuable in the control of hemostasis in patients with ICH.