{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:42:20Z","timestamp":1792762940780,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The Clauss fibrinogen (CF) assay is the clinical standard for detecting hypofibrinogenaemia in traumatic intracranial haemorrhage (TICH). This assay, however, is time\u2010intensive limiting rapid coagulopathy management. FIBTEM, a module of the rotational thromboelastometry (ROTEM)\n                      <jats:italic>Sigma<\/jats:italic>\n                      device, alternatively provides a rapid point\u2010of\u2010care assessment of fibrin contribution to clot firmness. In many centres, FIBTEM is used as a surrogate for CF. Recently, the FIBTEM cartridge has been modified to include tirofiban in addition to cytochalasin, shifting from a single to dual anti\u2010platelet formulation. The impact of this change on the established FIBTEM\u2013CF relationship remains uncertain, and it is unclear if FIBTEM thresholds typically thought to corroborate with reduced CF remain valid.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational cohort study between February 2022 and 2025, evaluating the relationship between FIBTEM and CF before and after the cartridge modification at our institute. Eligible participants were patients with TICH and a Glasgow Coma Scale \u2264\u200914 who underwent FIBTEM and CF testing on simultaneously drawn samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The linear relationship between FIBTEM and CF was not influenced by cartridge type (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.82). Diagnostic performance (AUROCs: 0.94 versus 0.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.71) and the optimised cut\u2010point (FIBTEM A5  8\u2009mm) for the detection of hypofibrinogenaemia were also comparable between the single and dual anti\u2010platelet systems.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Similar relationships between FIBTEM and CF were observed for single and dual anti\u2010platelet FIBTEM systems in TICH. Thresholds for fibrinogen replacement may be generalisable between single and dual anti\u2010platelet FIBTEM systems; however, external validation is necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70170","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:30:43Z","timestamp":1763357443000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["What the Sigma? Exploring the Change From Single to Dual Anti\u2010Platelet\n                    <scp>ROTEM<\/scp>\n                    on the\n                    <scp>FIBTEM<\/scp>\n                    to Clauss Fibrinogen Relationship\u00a0in Neurotrauma"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-7130","authenticated-orcid":false,"given":"Abhiram","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":"Mahni","family":"Foster","sequence":"additional","affiliation":[{"name":"Trauma Department Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Dillon","family":"Ovenden","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kit Yan","family":"Wong","sequence":"additional","affiliation":[{"name":"Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngee","family":"Foo","sequence":"additional","affiliation":[{"name":"Trauma Department Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lola","family":"Kaukas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Reddi","sequence":"additional","affiliation":[{"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":"Trauma Department Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq161"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.11.021"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00332-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04752.x"},{"key":"e_1_2_10_6_1","article-title":"Low FIBTEM Amplitude in Neurotrauma: True Plasma Fibrinogen Depletion or Functional Fibrin Activity Reduction?","author":"Hiwase A. D.","journal-title":"Journal of Trauma and Acute Surgery"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00264-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyab358"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14670"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14480"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2010.1744"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01639-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.922879"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/293302a0"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14356"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.51893\/2021.1.OA3"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182a1afac"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000058"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16455"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.12.4.399"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2022.11.036"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375-9393.22.15912-2"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70170","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.70170","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:29:26Z","timestamp":1792762166000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,16]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/1742-6723.70170"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70170","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,16]]},"assertion":[{"value":"2025-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70170"}}