Establishment of normal reference range for thromboelastography based on 17,708 cases in Beijing, China

BACKGROUND: Thromboelastography (TEG) can dynamically evaluate the interaction between platelets and coagulation cascade and the effects of other cellular components on the activities of plasma factors, to comprehensively analyze the whole process of blood coagulation and dissolution. Due to differences in both the incidence rates and the coagulation state of related diseases, many studies have highlighted the necessity of establishing the normal reference ranges for TEG for local regions. The aim of the present study was to determine the local normal reference ranges according to the TEG results of 17,708 volunteers in Beijing, to explore the coagulation characteristics related to the age and sex of the study population. METHODS: Reference ranges of reaction time (R), coagulation time (K), coagulation angle (α-angle), and maximum thrombus consistency (MA) for TEG in healthy adults in Beijing were determined in the physical examination of 17,708 Beijing volunteers (5,319 women and 12,389 men). The volunteers were divided into the elderly group (≥60 years old) and young and middle-aged group (20–59 years old), and the reference ranges of each group were calculated according to sex. RESULTS: Based on the TEG results of the 17,708 volunteers who underwent physical examination, the 95% reference ranges of R, K, α-angle, and MA for TEG in Beijing were 5.1–10 min, 1.3–3.8 min, 44.9–70.2°, and 50.4–71 min, respectively. The results of R, K, α-angle, and MA for TEG between the young and middle-aged group and the elderly group, as well as between women and men were significantly different (P<0.001). Finally, reference ranges for TEG in the young and middle-aged group and the elderly group were obtained. CONCLUSIONS: Compared with the reference standards provided by previous reagent manufacturers, the coagulation factor and fibrinogen function of TEG tend to be hypocoagulable in Beijing population. We found that the young and middle-aged group had lower coagulation activity than the elderly group, and women had higher coagulation activity than men in the same group.