{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:07:23Z","timestamp":1773385643379,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001078","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","award":["233R38\u20102022\u2010LATONA"],"award-info":[{"award-number":["233R38\u20102022\u2010LATONA"]}],"id":[{"id":"10.13039\/501100001078","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"Abstract<\/jats:title>\n \n Background and Objectives<\/jats:title>\n The role of viscoelastic haemostatic assays (VHAs) versus conventional coagulation tests (CCTs) in chronic liver disease (CLD) in the emergency department (ED) is undefined. We aimed to characterize VHA profiles and concordance with CCT.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n Patients with\n CLD<\/jats:styled-content>\n presenting to\n EDs<\/jats:styled-content>\n (January 2016\u2013August 2023) were included. Post\u2010transfusion results were excluded.\n VHA<\/jats:styled-content>\n was categorized as hypo\/normo\/hypercoagulable using manufacturer ranges.\n CCT<\/jats:styled-content>\n \u2010coagulopathy was defined as international normalized ratio (\n INR)<\/jats:styled-content>\n >1.5, platelets <50\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L or fibrinogen <1.0\u2009g\/L.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n VHA<\/jats:styled-content>\n use increased over time (incidence rate ratio [\n IRR]<\/jats:styled-content>\n 1.23, 95% confidence interval [\n CI]<\/jats:styled-content>\n : 1.19\u20131.28;\n p<\/jats:italic>\n \u2009<\u20090.001). Of 438 patients, 397 underwent rotational thromboelastometry\n (ROTEM)<\/jats:styled-content>\n and 41 thromboelastography (\n TEG)<\/jats:styled-content>\n .\n ROTEM<\/jats:styled-content>\n showed hypocoagulability in 275 patients (69%), normocoagulability in 84 (21%), hypercoagulability in 18 (5%) and mixed profiles in 14 (4%). Deficits were fibrinogen deficiency in 220 patients (55%), factor deficiency in 148 (37%), hyperfibrinolysis in 42 (11%) and platelet deficiency in 33 (8%). TEG showed hypocoagulability in 22 (54%), normocoagulability in 13 (32%), hypercoagulability in 3 (7%) and mixed profiles in 3 (7%). Deficits included fibrinogen deficiency in 19 patients (46%), factor deficiency in 6 (15%), hyperfibrinolysis in 5 (12%) and platelet deficiency in 3 (7%). In 120 VHA\u2013CCT paired results, fibrinogen deficiency was detected by both in 18%, VHA alone 26%, CCT alone 2%; platelet deficiency by both 5%, VHA alone 5%, CCT alone 5%; factor deficiency by both 22%, VHA alone 3% and CCT alone 42%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Hypocoagulability from reduced fibrin\u2010based clot strength was predominant. Marked discordance between\n VHA<\/jats:styled-content>\n and\n CCT<\/jats:styled-content>\n was observed in coagulation factor deficiency.\n CLD<\/jats:styled-content>\n \u2010specific thresholds are required to guide transfusion.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/vox.70167","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:35:53Z","timestamp":1766036153000},"page":"309-321","source":"Crossref","is-referenced-by-count":0,"title":["Viscoelastic haemostatic assays in chronic liver disease\u2014Profiling coagulation in the emergency department"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-2588","authenticated-orcid":false,"given":"Akmez","family":"Latona","sequence":"first","affiliation":[{"name":"Emergency Department Ipswich Hospital Ipswich Queensland Australia"},{"name":"LifeFlight Retrieval Medicine Toowoomba Queensland Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Faculty of Medicine The University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4377-7608","authenticated-orcid":false,"given":"Kate","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Haematology Princess Alexandra Hospital Woolloongabba Queensland Australia"},{"name":"Pathology Queensland, Metro South Health Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Haematological Medicine King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Woolloongabba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Winearls","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Gold Coast University Hospital Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-2450","authenticated-orcid":false,"given":"Biswadev","family":"Mitra","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Emergency & Trauma Centre Alfred Health Melbourne Victoria Australia"},{"name":"1 Expeditionary Health Squadron, Royal Australian Air Force Amberley Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00047-X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2019.05.007"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002905"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14058"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.457"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15239"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.08021.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2018.7.37893"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.70131"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2023.09.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v12.i11.1115"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05939-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.05.144"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001214"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28148"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30794"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0672-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13121"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_9_21_1","unstructured":"ACEM.Guidelines on the implementation of the Australasian Triage Scale in emergency departments. 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