Abstract 058: Outcomes in Patients with Spontaneous Intracranial Hemorrhage Who Underwent Thromboelastography Testing

Introduction In the U.S., intracerebral hemorrhage (ICH) accounts for 10‐15% of all strokes, yet it carries a significantly higher risk of death or long‐term disability. While the Thromboelastography Platelet (TEG PM) mapping tool is well‐established for managing coagulopathy in trauma, organ transplantation, massive transfusions, and ECMO patients, its use in spontaneous ICH is not well understood. This study aims to evaluate patient outcomes in spontaneous ICH cases that received TEG testing compared to those that did not. Method Following IRB approval, we conducted a retrospective review of 215 patients with intracerebral hemorrhage (ICH) from June 2020 to June 2023. Out of these, 160 had spontaneous ICH, with 98 undergoing TEG‐PM testing and 62 not. The primary outcome was to evaluate the frequency of platelet transfusions and complications related to external ventricular drains (EVD). The secondary outcome was to compare discharge outcomes, using discharge status as a proxy for functional recovery, with discharge to home or acute rehab considered a good outcome. Chi‐square tests were performed to analyze differences between the TEG and non‐TEG groups, with all analyses conducted using IBM SPSS Statistics. Results We performed a Mann‐Whitney U test to compare ICH volume and initial National Institutes of Health Stroke Scale (NIHSS) scores between the two groups. The results showed that ICH volume was significantly lower in the non‐TEG‐PM group, with a p‐value of 0.002. The median ICH volume of TEG‐PM group was 13 (IQR 4.0‐36.0), while in non‐TEG‐PM group was 4.35 (IQR 1.0‐19.6). There was no significant difference in the initial NIHSS scores between the groups (p=0.063). In patients who underwent TEG‐PM, 10.2% received platelet transfusion as compared to non‐TEG‐PM group where 0% patients received platelet transfusion with p‐value of 0.009. In TEG‐PM group, 26.8 % patients had EVD placement vs 9.7 % in non‐TEG‐PM group with Odds Ratio 0.29 (0.11‐0.76). There was 1% EVD associated hemorrhage seen in patients of TEG‐PM group as compared to 0% in non‐TEG‐PM. 44.9% of the patients in the TEG‐PM had good discharge outcome as compared to 64.5% in non‐TEG‐PM group with p‐value of 0.1 Conclusion The data indicates that TEG‐PM testing is not a reliable predictor of patient outcomes in spontaneous ICH. Interestingly, patients who underwent TEG‐PM testing received more platelet transfusions compared to those who did not, but this did not impact the discharge outcomes. The ICH volume in both groups were not clinically significant.