Correlation of thromboelastography with coagulation function, inflammatory and blood gas indexes in patients with acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective To analyze and compare the correlation between thromboelastography and routine coagulation function, inflammatory index and blood gas analysis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients during hospitalization. Methods From August 2016 to January 2019, a retrospective cross-sectional study was carried out on 40 AECOPD patients admitted to the emergency department of Shanghai Oriental Hospital or the Emergency Intensive Care Unit, including 23 males and 17 females, aged 58-95 years, with average 79.75 years in 23 males and 17 females to analyze the correlation between TEG and coagulation index, blood gas analysis, inflammatory index; kappa analysis was used to evaluate the consistency between TEG and coagulation function. Results The K value of AECOPD patients was negatively correlated with FIB (r=-0.42), positively correlated with APTT (r=0.67), TT (r=0.49); R value was positively correlated with APTT (r=0.49), α angle was positively correlated with FIB (r=0.39), and negatively correlated with APTT (r=-0.61); Ma was positively correlated with FIB (r=0.68), and negatively correlated with APTT (r=-0.60) and TT (r=-0.37); Ci was positively correlated with FIB (r=0.41), and negatively correlated with APTT (r=-0.69) and TT (r=-0.37). The difference was statistically significant (P<0.05). The kappa values of FIB, K and MA were 0.35 and 0.47, respectively, with statistical significance (P<0.05); The kappa values of APTT, K value, R value, Ma value and α angle were 0.48, 0.49, 0.31 and 0.33 respectively, the difference was statistically significant (P<0.05). In addition, MA was positively correlated with CRP (r=0.39). The indexes of TEG were also correlated with the indexes of arterial blood gas analysis: K value was negatively correlated with pH value of arterial blood (r=-0.36), positively correlated with PaCO2 (r=0.37) and Lac (r=0.48); R value was negatively correlated with pH value of arterial blood (r=-0.39), positively correlated with PaCO2 (r=0.35), and α angle was negatively correlated with lac level of arterial blood (r=-0.45); MA was positively correlated with PaO2 (r=0.33) and negatively correlated with lac (r=-0.42); CI was positively correlated with arterial pH (r=0.37), negatively correlated with PaO2 (r=-0.37) and Lac (r=-0.41), and the difference was statistically significant (P<0.05). Conclusion The thromboelastography of patients with AECOPD has a certain correlation with coagulation parameters, C-reactive protein, and blood gas analysis indicators, and it has practical implications for assessing coagulation, inflammation, and internal environmental conditions in patients with AECOPD. Key words: Thromboelastography; Acute exacerbation of chronic obstructive pulmonary disease; Coagulopathy dysfunction