Comparison of the Quantra® QPlus sonorheometry with conventional hemostasis laboratory and TEG-5000® parameters

Abstract

Objective

To compare and evaluate, a new viscoelastic point-of-care device, the Quantra QPlus® parameters with conventional hemostasis tests and TEG-5000® parameters.

Design, Material and Methods

This prospective homocentric observational study took place between January and June 2024 at the main community site Hospital, Jolimont’s Hospital on adult patients undergoing elective cardiac surgery using cardiopulmonary bypass (CPB). Paired perioperative citrated and EDTA blood samples were collected and sent directly to the laboratory for analysis. The blood was analyzed in one hand with TEG-5000® (K, MA and alpha angle) in cardiac operating room and afterwards, simultaneously with Quantra QPlus® (CTH, FCS, PCS), citrate platelet count with specific fluorescent agent (PLT-F) and standard haemostasis testing (PT/INR, aPTT, Clauss Fibrinogen).

Results

Method comparison analysis shows that Quantra’s Parameters PCS and FCS were well correlated with PLT-F and Fibrinogen while TEG-5000® parameter were less. FCS and Alpha Angle predicted a Clauss Fibrinogen <150 mg/dL with an area under the curve (AUC) respectively of 0.899 (n = 66) and 0.815 (n = 54). PCS and MA predicted a Platelet count <150k/µL with an AUC of 0.793 (n = 62) and 0.807 (n = 54) respectively. CTH and K predicted an aPTT (actin FS on CS-5100) >29,0s with an AUC of 0.864 (n = 60) and 0.702 (n = 60) respectively.

Conclusion

Strong correlations were observed between quantra parameters FCS and PCS with Clauss Fibrinogen and Platelet count. While Performance from ROC curves for predicted thrombocytopenia <150k platelet/µL is similar with TEG-5000, they are better for predicted fibrinogen concentration and prolonged aPTT.