{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:48Z","timestamp":1787013708234,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001039","name":"Neurosurgical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001039","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Coagulation assessment in traumatic brain injury (TBI) typically relies upon laboratory\u2010based standard coagulation tests (SCTs), including the activated partial thromboplastin time (aPTT), INR and platelet count. Rotational thromboelastometry (ROTEM) sigma is an alternative point\u2010of\u2010care assay; however, its role in isolated TBI is under\u2010evaluated. The present study aims to assess the prognostic utility of ROTEM sigma in isolated TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ROTEM sigma analysis was performed during the initial evaluation of patients presenting to the Royal Adelaide Hospital between February 2022 and 2023 with radiographically demonstrated traumatic intracranial haemorrhage and GCS \u226414. Patients with concomitant severe extracranial injury, or who received blood products or antifibrinolytic therapy prior to sample collection were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010six patients had blood samples analysed with ROTEM, 25 of these patients were also evaluated with paired SCTs. Twenty\u2010two per cent (8\/36) of patients with isolated TBI had a hypocoaguable ROTEM profile, and this was associated with an increased incidence of head injury\u2010related death (50% [4\/8]\n                      <jats:italic>vs<\/jats:italic>\n                      11% [3\/28],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03). Median diagnostic turn\u2010around\u2010times were shorter for ROTEM parameters compared to SCT counterparts: EXTEM clotting time (CT)\n                      <jats:italic>versus<\/jats:italic>\n                      INR (20\n                      <jats:italic>vs<\/jats:italic>\n                      63\u2009min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01), and INTEM CT\n                      <jats:italic>versus<\/jats:italic>\n                      aPTT (21\n                      <jats:italic>vs<\/jats:italic>\n                      63\u2009min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). EXTEM CT, FIBTEM CT and INR values had similar performance in predicting head injury\u2010related death, area under the receiver operator curves were 0.8, 0.8 and 0.7, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ROTEM sigma expedites the detection of clinically significant coagulopathy in isolated TBI. EXTEM and FIBTEM CT values are more rapidly attainable than INR and comparable in predicting head injury\u2010related death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.14480","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T23:09:06Z","timestamp":1724108946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Can rotational thromboelastometry rapidly identify theragnostic targets in isolated traumatic brain injury?"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-7130","authenticated-orcid":false,"given":"Abhiram D","family":"Hiwase","sequence":"first","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D","family":"Ovenden","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lola M","family":"Kaukas","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Finnis","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Australian Institute for Machine Learning, University of Adelaide  Adelaide South Australia Australia"},{"name":"The Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngee","family":"Foo","sequence":"additional","affiliation":[{"name":"Department of Trauma Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Reddi","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Intensive Care Medicine Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J","family":"Wells","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Y","family":"Ellis","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Trauma Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0390-5616.18.04532-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-01151-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.2233"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-007-1475-8"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14670"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyab358"},{"key":"e_1_2_9_8_1","article-title":"Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding","volume":"2016","author":"Wikkels\u00f8 A","year":"2016","journal-title":"Cochrane Database Syst. 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