{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:52:15Z","timestamp":1789825935865,"version":"4.0.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014\u2013February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Neonatal illness severity scores (Modified NEOMOD [Neonatal Multiple Organ Dysfunction] and SNAPPE [Score for Neonatal Acute Physiology with Perinatal Extension]) were calculated at the same time as ROTEM analysis. Mortality during in-hospital stay was the main outcome measure. Multivariable analyses showed that a 10\u2009mm decrease in EXTEM clot amplitude recorded at 10\u2009minutes (A10) is significantly associated with a higher mortality (odds ratio [OR]\u2009=\u20091.69, 95% confidence interval [CI]: 1.33\u20132.08). Higher modified NEOMOD (OR\u2009=\u20091.36, 95% CI: 1.26\u20131.47) and higher SNAPPE scores (OR\u2009=\u20091.06, 95% CI: 1.04\u20131.08) were also associated with increased mortality. The CT and A10 variables demonstrated the best prognostic performance among the EXTEM parameters for mortality (area under the curve [AUC]\u2009=\u20090.78; 95% CI: 0.69\u20130.86 and AUC\u2009=\u20090.76; 95% CI: 0.66\u20130.85, respectively), showing an optimal cut-off CT \u226563\u2009seconds and A10 \u226437\u2009mm. Using optimal cut-off values of the EXTEM parameters for prediction of mortality, neonates with CT \u226563\u2009seconds were 7.4 times more likely to die (OR\u2009=\u20097.40, 95% CI: 3.50\u201315.65), while neonates with A10 \u226437\u2009mm were 5.8 times more likely to die (OR\u2009=\u20095.88, 95% CI: 2.94\u201312.50). An EXTEM hypocoagulable profile on disease onset was shown to be an independent risk factor for in-hospital mortality in neonatal critical illness.<\/jats:p>","DOI":"10.1055\/s-0041-1729964","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T22:42:07Z","timestamp":1623796927000},"page":"875-884","source":"Crossref","is-referenced-by-count":27,"title":["Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study"],"prefix":"10.1055","volume":"47","author":[{"given":"Andreas G.","family":"Tsantes","sequence":"first","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozeta","family":"Sokou","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Konstantinidi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Ioakeimidis","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lampridou","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavroula","family":"Parastatidou","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Theodoraki","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikaia, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Piovani","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Iliodromiti","sequence":"additional","affiliation":[{"name":"Neonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Boutsikou","sequence":"additional","affiliation":[{"name":"Neonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Iacovidou","sequence":"additional","affiliation":[{"name":"Neonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Douramani","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristarchos","family":"Poulis","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Styliani","family":"Kokoris","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios G.","family":"Kriebardis","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Egaleo, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanos","family":"Bonovas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argirios 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