Scholarlink

<p>Spontaneous intracerebral hemorrhage (ICH) accounts for about 10% of strokes in the United States and is linked to high mortality and morbidity. Hematoma expansion independently predicts poor outcomes. Thromboelastography with platelet mapping (TEG-PM) has shown predictive value for hematoma expansion in traumatic ICH, but its role in spontaneous ICH is unclear. This retrospective cohort study assessed the predictive value of TEG-PM, focusing on arachidonic acid (AA) and adenosine diphosphate (ADP) inhibition, for hematoma expansion in spontaneous ICH patients. Patients with ICH who received TEG-PM and an initial CT scan within 6&#xa0;h of hospital presentation between January 2018 and April 2024 were included. Hematoma volume was calculated using the ABC/2 method. Hematoma expansion was defined as a relative growth of more than 33% or an absolute increase greater than 6 mL from initial CT. The primary outcome was the predictive value of TEG-PM findings on hematoma expansion. Among 117 patients (median age 62 years; 61.5% male), hematoma expansion occurred in 19 (16.2%). TEG-PM parameters—AA% (6.0% vs. 9.9%; <i>p</i> = 0.37) and ADP% inhibition (16.1% vs. 21.0%; <i>p</i> = 0.77)—did not differ significantly between those with and without expansion. Use of hemostatic agents like desmopressin (12.0%) and tranexamic acid (18.8%) was similar. In-hospital mortality occurred in 17.1%, with no significant difference by expansion status (21.1% vs. 16.3%; <i>p</i> = 0.62). TEG-PM parameters did not predict hematoma expansion in this cohort. The low expansion rate may have limited the predictive value of TEG-PM. These results suggest limited utility of TEG-PM to guide management in spontaneous ICH patients without overt platelet dysfunction or anticoagulation.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictive value of thromboelastography with platelet mapping on hematoma expansion in spontaneous intracerebral hemorrhage

  • 期刊论文

  • 发表日期：

    2026年4月29日

查看全文
  • Nora Sammani,
  • John J. Radosevich,
  • Sydni Martinez,
  • Travis Lam,
  • Daniel Gonzalez,
  • Tracie Schroeder,
  • Sai Alekha Challa,
  • John Tyler Haller

摘要

Spontaneous intracerebral hemorrhage (ICH) accounts for about 10% of strokes in the United States and is linked to high mortality and morbidity. Hematoma expansion independently predicts poor outcomes. Thromboelastography with platelet mapping (TEG-PM) has shown predictive value for hematoma expansion in traumatic ICH, but its role in spontaneous ICH is unclear. This retrospective cohort study assessed the predictive value of TEG-PM, focusing on arachidonic acid (AA) and adenosine diphosphate (ADP) inhibition, for hematoma expansion in spontaneous ICH patients. Patients with ICH who received TEG-PM and an initial CT scan within 6 h of hospital presentation between January 2018 and April 2024 were included. Hematoma volume was calculated using the ABC/2 method. Hematoma expansion was defined as a relative growth of more than 33% or an absolute increase greater than 6 mL from initial CT. The primary outcome was the predictive value of TEG-PM findings on hematoma expansion. Among 117 patients (median age 62 years; 61.5% male), hematoma expansion occurred in 19 (16.2%). TEG-PM parameters—AA% (6.0% vs. 9.9%; p = 0.37) and ADP% inhibition (16.1% vs. 21.0%; p = 0.77)—did not differ significantly between those with and without expansion. Use of hemostatic agents like desmopressin (12.0%) and tranexamic acid (18.8%) was similar. In-hospital mortality occurred in 17.1%, with no significant difference by expansion status (21.1% vs. 16.3%; p = 0.62). TEG-PM parameters did not predict hematoma expansion in this cohort. The low expansion rate may have limited the predictive value of TEG-PM. These results suggest limited utility of TEG-PM to guide management in spontaneous ICH patients without overt platelet dysfunction or anticoagulation.

Graphical Abstract