PB1114 - Method Comparison Analysis of Quantra relative to Rotational Thromboelastometry and Conventional Coagulation Testing in Cirrhosis

Background: Hemostatic abnormalities are commonly observed in cirrhotic patients, placing them at an increased risks for bleeding. Conventional coagulation testing (CCT) has traditionally been used to guide the transfusion of blood components. At present, there is limited clinical data evaluating the interchangeability of viscoelastic testing (VET) devices in cirrhosis. The Quantra platform is a VET device that utilizes ultrasound to characterize viscoelastic properties of a blood clot.

Aims: To evaluate the correlation and agreement between Quantra, thromboelastometry (ROTEM), and CCT results in patients with cirrhosis

Methods: Samples collected from 61 adult patients with a clinical diagnosis of decompensated cirrhosis were evaluated in parallel using Quantra (QPlus Cartridge), ROTEM, and CCT. Comparable test parameters between testing methods were compared as described in Table 2. Method comparison analyses were performed using Deming Regression to assess the correlation between comparable parameters. Spearman correlation was used to test parameter associations

Results: Patients characteristics are demonstrated in Table 1. Deming regression analysis indicated a weak to very strong correlation between Quantra and ROTEM parameters, with Spearman correlation coefficient values (rs) between 0.37 to 0.96 (Table 2). Correlations between VET platform clotting times and corresponding CCT parameters and CTH and HEPTEM CT were weak. A strong to very strong correlation was observed between FCS and fibrinogen concentration, and PCS and platelet count (rs=0.60 and rs=0.88, respectively). Despite showing acceptable correlation, Deming regression showed significant constant and proportional biases when comparing parameters.

Conclusion(s): Findings from this method comparison study demonstrate that clot stiffness Quantra parameters correlated strongly with corresponding parameters from ROTEM as well as fibrinogen and platelet levels. However, observed biases following Deming regression analysis indicate that these viscoelastic platforms are not interchangeable; local reference ranges should be established before adopting and clinical use of alternative platforms.