{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:45:18Z","timestamp":1789872318157,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Trauma\u2010induced coagulopathy (TIC) can be fatal but preventable if recognised early. With emerging uses of rotational thromboelastometry (ROTEM) to guide transfusions in trauma, patient outcomes with TIC\u2010defined by initial ROTEM and conventional coagulation tests (CCTs) during massive haemorrhage protocol (MHP) activations were evaluated at a primary trauma centre in British Columbia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational study included adult trauma patients requiring MHP from June 1, 2020, to May 31, 2022. TIC, defined by initial results including (1) ROTEM\u2010based EXTEM A10 &lt;40\u2009mm, EXTEM CT &gt;100\u2009s, EXTEM ML30 &gt;10%, FIBTEM A10 &lt;10\u2009mm; and (2) CCT\u2010based INR \u22651.8, PTT \u22651.5\u2009times of upper normal limit, platelets &lt;50\u2009x\u200910<jats:sup>9<\/jats:sup>\/L, and Clauss Fibrinogen &lt;1.5\u2009g\/L, was assessed for its correlation with mortality. Modified Poisson regression was used to model 28\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two of sixty\u2010eight patients (32%) had abnormal ROTEM but normal CCTs. TIC defined by CCTs was associated with increased mortality [24\u2009h: 5\/13 (38%) vs. 5\/55 (9%), <jats:italic>p<\/jats:italic>\u2009=\u20090.025; 28d: 8\/13 (62%) vs. 11\/55 (20%), <jats:italic>p<\/jats:italic>\u2009=\u20090.002]; compared to ROTEM, which was not [24\u2009h: 7\/35 (20%) vs. 3\/33 (9%), <jats:italic>p<\/jats:italic>\u2009=\u20090.307; 28d: 11\/35 (31%) vs. 9\/33 (27%), <jats:italic>p<\/jats:italic>\u2009=\u20090.594], despite requiring significantly higher blood component transfusion within the first 4 and 24\u2009h of MHP (<jats:italic>p<\/jats:italic>\u2010values&lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ROTEM is more sensitive in identifying TIC. Patients with abnormal CCTs had a higher death rate, and those with abnormal ROTEM had no significantly increased mortality. A prospective study is required to assess the effects of ROTEM further.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.13128","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T03:44:35Z","timestamp":1737776675000},"page":"266-274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of conventional coagulation tests and <scp>ROTEM<\/scp> in identifying trauma\u2010induced coagulopathy for massive haemorrhage protocol activation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7730-6791","authenticated-orcid":false,"given":"Sakara","family":"Hutspardol","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Vancouver Coastal Health Authority  Vancouver British Columbia Canada"},{"name":"Department of Pathology and Laboratory Medicine University of British Columbia  Vancouver British Columbia 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Vancouver Coastal Health Authority  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zamar","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Vancouver Coastal Health Authority  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Vancouver Coastal Health Authority  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Vancouver Coastal Health Authority  Vancouver British Columbia Canada"},{"name":"Department of Pathology and Laboratory Medicine University of British Columbia  Vancouver British Columbia Canada"},{"name":"Centre for Blood Research University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey","family":"Hawes","sequence":"additional","affiliation":[{"name":"Trauma and Acute Care Surgery Vancouver General Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7107-2595","authenticated-orcid":false,"given":"Andrew W.","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Centre for Innovation Canadian Blood Services  Ottawa Ontario 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