Comparison of Mortality Impact of Coagulation Rotative Thromboelastometry Analysis Versus Standard Analysis

Comparison of Mortality Impact of Coagulation Rotative Thromboelastometry Analysis Versus Standard Analysis (Prothrombin Ratio) for Patients With Digestive Hemorrage

Digestive hemorrhage is a common cause of acute hemorrhage in France, and its mortality remains high despite improvement of endoscopy technique and therapeutics. Hemostasis disorders are an important issue in the patient care both in severity diagnostic and therapeutic plan.

Standard technique of coagulation analysis (prothrombin ratio, activated partial thromboplastin time, fibrinogen and platelet count) do not provide to guide practitioner in reanimation of hemostatic patients in particular when coagulation defect preexisting to the digestive hemorrhage.

In this respect, the main objective of this study is to evaluate the interest of rotative thromboelastometry in the care of patient with digestive hemorrhage and its mortality impact.

Inclusion Criteria:

• Hospitalized patient in reanimation unit or continuous monitoring for digestive hemorrhage before or immediately after digestive endoscopy
• Digestive hemorrhage diagnostic: melena and/or rectal bleeding and/or hematemesis
• Affiliation to the social security
• Have signed an informed consent

Exclusion Criteria:

• Pregnant or nursing woman
• Without digestive fibroscopy
• With an anticoagulant treatment
• With a congenital coagulopathy
• Decision of therapeutic limitation or moribund patient
• With a digestive hemorrhage after an hospitalisation in reanimation unit for an other reason
• Participation in an other study in previous 30 days
• Under trusteeship, guardianship or judicial safeguards