Thromboelastography in elective total hip arthroplasty

Table 1 Baseline patient comorbidities according to anesthetic technique

	Spinal (n = 32)	GA (n = 20)	P value
Median age	74	61	< 0.01
Median weight (kg)	70	70	0.67
Sex (male)	14	7	0.23
ASA class 2	17	13	0.56
ASA class 3	15	7
Ischemic heart disease	1	0	> 0.99
Cerebrovascular disease	0	0
Diabetes	3	1
Hypertension	6	4
Smoking history	4	4

GA: General anesthesia; ASA: American society of anesthesiologists.

Table 2 Perioperative thromboelastography findings in patients undergoing total hip arthroplasty

TEG parameter	Type	Baseline	Mid-point of surgery	End of surgery	Post-op day 1	Post-op day 2	Post-op day 5
Reaction time (R time, min)	GA	3.0 (2.6-3.6)	2.4 (1.8-3.1)	2.2 (1.8-2.4)	2.9 (2.1-3.8)	3.1 (2.3-5.0)	4.0 (2.4-5.2)
	SA	3.0 (2.7-3.8)	2.5 (1.3-3.0)a	2.2 (1.4-2.4)b	2.9 (2.3-41)	2.8 (2.3-3.7)	3.8 (2.7-5.7)
Clot kinetics time (K time, min)	GA	4.2 (3.6-5.1)	3.3 (2.5-4.1)	3.0 (2.8-3.4)	3.9 (2.6-5.6)	3.7 (2.7-6.4)	5.3 (3.3-7.1)
	SA	4.4 (3.8-5.1)	3.2 (2.0-4.1)a	2.8 (2.3-3.3)b	4.2 (3.2-5.8)	3.7 (2.9-5.0)	5.4 (3.9-8.0)
Clot formation angle (degrees)	GA	36 (30-43)	50 (39-58)	43 (34-53)	44 (33-54)	46 (31-58)	41 (33-50)
	SA	35 (29-40)	47 (36-57)b	45 (40-57)b	43 (28-49)	49 (37-57)b	36 (25-47)
Maximum amplitude (mm)	GA	62 (56-68)	68 (63-71)	65 (54-71)	71 (66-76)a	77 (70-81)b	77 (74-81)b
	SA	61 (54-65)	64 (59-69)	63 (58-68)	69 (66-75)b	74 (70-81)b	78 (72-82)b
Clot lysis (LY60%)	GA	5 (3-6)	4 (3-7)	4 (2-7)	6 (2-7)	5 (3-6)	3 (1-4)
	SA	4 (4-6)	4 (2-5)	4 (2-4)	7 (5-10)a	5 (4-9)	3 (2-7)

All results are presented as median with interquartile range.

^aP < 0.05.

^bP < 0.01 compared to baseline in each group. GA: General anesthesia; SA: Spinal anesthesia; TEG: Thromboelastography; LY60%: Fibrinolysis index. (Normal reference ranges: R time: 4-9 min, K time: 1-3 min. Angle: 59-74 degrees, Maximum amplitude: 55-70 millimeters, LY60: 0%-8%)

Table 3 Perioperative conventional coagulation test findings in patients undergoing total hip arthroplasty

Conventional coagulation test	Anesthetic type	Baseline	Post-op day 5
Prothrombin time (min)	GA	12 (12-12)	12 (11-12)
	SA	12 (12-13)	12 (12-13)
INR	GA	0.9 (0.9-1.0)	0.9 (0.9-1.0)
	SA	1.0 (0.9-1.0)	1.0 (0.9-1.0)
aPTT (sec)	GA	32 (30-35)	32 (29-35)
	SA	32 (30-34)	32 (29-34)
Fibrinogen level (g/dL)	GA	3.1 (2.9-3.3)	4.6 (4.1-5.3)b
	SA	3.1 (2.9-3.6)	4.5 (4.0-4.9)b

All results are presented as median with interquartile range.

^bP < 0.01 compared to baseline in each group. GA: General anesthesia; SA: Spinal anesthesia; INR: International normalized ratio; aPTT: Activated partial thromboplastin time.