Association between Thrombelastography System and Vascular Obstructions and Hemorrhage: A Two-Year Follow-Up Study of Elderly Chinese Patients

Objectives. This study was designed to test the hypothesis that prior thrombelastography (TEG) indices are associated with subsequent vascular obstructions and hemorrhage events in aged populations, as well as to obtain knowledge about the distribution of TEG indices in elderly Chinese patients. Methods. We conducted a two-year follow-up study. The study population consisted of patients older than 65 years who had TEG in the Chinese PLA General Hospital between January 2007 and December 2010. Four hundred and three patients were enrolled in our study. They received TEG measurements upon being enrolled in this study. We collected information on demographics, clinical examinations, and outcomes during the observational period. Structural equation modeling (SEM) was used to analyze the relationship between "synthesized" TEG parameter indices and the outcome via an indicator pathway. Results. We found that in the "model of hemorrhage" (adjusted by confounding of anticoagulants), the model fit indices with chi- square/df = 9.555/7, CFI of 0.997, TLI of 0.994, and standardized root mean square residual (SRMR) of 0.034; while in the "model of vascular obstruction events" (adjusted by confounding of Anticoagulants), the model fit indices with chi-square/df = 6.070/7, CFI of 1.000, TLI of 1.002, and standardized root mean square residual (SRMR) of 0.000. The "model of vascular obstruction events" showed that the "synthesized" TEG parameter was significantly associated with vascular obstruction events, while this significance was not found in the "model of hemorrhage". Conclusions. Previous TEG indices are significantly associated with the subsequent vascular obstruction events in the elderly population. Future study can test this association and provide more information for clinical use.