{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:51:16Z","timestamp":1785887476947,"version":"3.56.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"abstract":"<jats:p>Thrombocytopenia contributes to trauma-induced coagulopathy and may require platelet transfusion. Viscoelastic assays can provide rapid surrogates of platelet count, but thresholds may be influenced by physiological derangements. We compared ROTEM-derived parameters for diagnosing thrombocytopenia and tested their robustness across selected conditions.<\/jats:p>\n                  <jats:p>We performed a retrospective registry-based cohort study in a level 1 trauma center (2011\u20132021). Severely injured adults were included if they had at least one paired ROTEM and platelet count measurement within 24\u2009hours of admission; patients receiving anticoagulants were excluded. Thrombocytopenia was defined as platelets &lt;100 G\/L. Associations between platelet count and ROTEM parameters were assessed with Spearman correlation. Diagnostic accuracy was evaluated using ROC and precision\u2013recall (PR) analyses; optimal thresholds were chosen by maximal F1-score. For the best parameter, performance was explored across hemoglobin level, acidosis, and hypocalcemia.<\/jats:p>\n                  <jats:p>Of 4,395 admissions, 865 patients were included with 1,395 paired measurements; thrombocytopenia occurred in 213 samples (15.3%) and was present at admission in 35 (4%). Platelet count correlated with clot amplitude\/elasticity (p\u2009&lt;\u20090.001). The platelet component of clot amplitude at 5\u2009minutes (A5 PLAT) had the best discrimination (AUC 0.929; AUPRC 0.627). The optimal PR-based threshold was A5 PLAT \u226421\u2009mm. Performance was mainly affected by severe acidosis and severe hypocalcemia.<\/jats:p>\n                  <jats:p>In severe trauma, ROTEM-derived A5 PLAT accurately identifies platelet count &lt;100 G\/L and outperforms other ROTEM parameters, supporting its use for rapid platelet-related decision-making. Hypocalcemia and acidosis may reduce precision and should be considered when applying ROTEM-based thresholds during early trauma resuscitation.<\/jats:p>","DOI":"10.1055\/a-2922-8113","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:40:18Z","timestamp":1784940018000},"source":"Crossref","is-referenced-by-count":0,"title":["Rotem Platelet Component (A5 Platelet) as a Rapid Marker of Thrombocytopenia after Severe Trauma"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6274-7044","authenticated-orcid":false,"given":"Jean-Stephane","family":"David","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Sud, Hospices Civils de Lyon, Rhone, France","place":["Pierre Benite"],"department":["Department of Anesthesia and Intensive Care"]},{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard Lyon I, France","place":["Marcy l'Etoile"],"department":["Unit\u00e9 APCSe UPSP"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Sibille","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Sud, Hospices Civils de Lyon, Rhone, France","place":["Pierre Benite"],"department":["Department of Anesthesia and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdi","family":"Rezigue","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["Service d'H\u00e9matologie Clinique et d'H\u00e9mostase"]},{"name":"Universit\u00e9 Lyon 1 Facult\u00e9 de M\u00e9decine Lyon-Est, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["UR4609 H\u00e9mostase et Thrombose"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Meltzer","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Sud, Hospices Civils de Lyon, Rhone, France","place":["Pierre Benite"],"department":["Department of Anesthesia and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Jallades","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["Service d'H\u00e9matologie Clinique et d'H\u00e9mostase"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Odile","family":"Geay-Baillat","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["Service d'H\u00e9matologie Clinique et d'H\u00e9mostase"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Nougier","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["Service d'H\u00e9matologie Clinique et d'H\u00e9mostase"]},{"name":"Universit\u00e9 Lyon 1 Facult\u00e9 de M\u00e9decine Lyon-Est, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["UR4609 H\u00e9mostase et Thrombose"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesim","family":"Dargaud","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["Service d'H\u00e9matologie Clinique et d'H\u00e9mostase"]},{"name":"Universit\u00e9 Lyon 1 Facult\u00e9 de M\u00e9decine Lyon-Est, Auvergne-Rh\u00f4ne-Alpes, France","place":["Lyon"],"department":["UR4609 H\u00e9mostase et Thrombose"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s13054-023-04327-7","article-title":"The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition","volume":"27","author":"R 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