ORIGINAL ARTICLESStandard and derived rotational thromboelastometry parameters for prediction of disseminated intravascular coagulation in septic patientsScarlatescu, Ecaterinaa; White, Nathan J.b; Tomescu, Dana R.a,cAuthor Information aDepartment of Anesthesia and Intensive Care III, Fundeni Clinical Institute, Bucharest, Romania bDepartment of Emergency Medicine, University of Washington, Seattle, Washington, USA cCarol Davila University of Medicine and Pharmacy, Bucharest, Romania Correspondence to Ecaterina Scarlatescu, MD, Department of Anaesthesia and Intensive Care III, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest 022328, Romania Tel: +40 743127924; e-mail: email@example.com Received 31 October, 2019 Revised 2 March, 2020 Accepted 2 April, 2020 Blood Coagulation & Fibrinolysis: July 2020 - Volume 31 - Issue 5 - p 317-323 doi: 10.1097/MBC.0000000000000919 Buy Metrics Abstract Waiting for lab tests results for the calculation of disseminated intravascular coagulation (DIC) scores leads to unwanted delays in diagnosis. The use of rotational thromboelastometry (ROTEM) for this purpose would allow for a more rapid DIC diagnosis at the bedside. The aim of this study was to assess the ability of standard ROTEM parameters and calculated parameters from the ROTEM velocity curve to predict DIC. The retrospective observational study included 97 septic patients. Japanese Association for Acute Medicine score was used for DIC diagnosis and whole-blood ROTEM was performed at study inclusion. Univariate analysis revealed delayed coagulation initiation and propagation and reduced clot firmness and maximum elasticity in DIC patients compared with patients without DIC. To adjust for confounders, multivariable logistic regression models were created and fibrinogen levels, prothrombin time and ROTEM parameters such as maximum clot firmness, maximum clot elasticity (MCE) and total thrombus formation [area under the curve (AUC)] were identified as significant predictors of DIC. According to receiver operating characteristics analysis, MCE and total thrombus formation (AUC) were the most useful ROTEM parameters for DIC prediction. MCE less than 158 (73% sensitive, 80% specific) and AUC less than 6175 mm × 100 (73% sensitive, 76% specific) predicted DIC in septic patients. Both standard and derived ROTEM parameters are useful for rapid DIC prediction in septic patients, allowing the timely identification of patients with higher mortality risk which might benefit from additional therapies. Further studies are needed to assess the clinical relevance of these findings. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.