Thromboelastography identified a hypercoagulable state in surgical patients at high risk for stroke, with the high D-dimer subgroup showing a significantly stronger hypercoagulable profile than the normal D-dimer group, suggesting TEG may be useful as a complementary preoperative tool in this population.
Key Findings
Results
Surgical patients at high risk for stroke exhibited a more hypercoagulable state than healthy participants as measured by thromboelastography parameters.
220 patients at high risk for stroke and 40 healthy controls were recruited from a large central hospital in China between December 2019 and March 2022.
Thromboelastography 5000 technology was used to acquire TEG parameters.
TEG parameters in high-stroke-risk patients were consistent with a hypercoagulable profile compared to healthy controls.
This was a cross-sectional study design.
Results
Among patients at high risk for stroke, those with elevated D-dimer levels showed a significantly stronger hypercoagulable profile than those with normal D-dimer levels.
Patients were stratified into high D-dimer and normal D-dimer subgroups within the high-stroke-risk cohort.
The high D-dimer group demonstrated a significantly stronger hypercoagulable state as measured by TEG parameters.
This subgroup comparison highlights D-dimer as a potential marker for identifying patients with more pronounced coagulation abnormalities preoperatively.
Results
The correlation between thromboelastography parameters and conventional coagulation tests was consistent with a hypercoagulable state in patients at high risk for stroke.
Both TEG parameters and conventional coagulation tests pointed toward hypercoagulability in the high-stroke-risk group.
TEG was evaluated as a complementary tool to conventional coagulation testing rather than a replacement.
The consistency between TEG and conventional tests supports the validity of TEG findings in this population.
Conclusions
Thromboelastography may be useful for identifying a preoperative hypercoagulable state in surgical patients at high risk for stroke, though its impact on clinical outcomes remains to be established.
The authors concluded that further research is needed to determine whether TEG-based detection of hypercoagulability translates into improved clinical decision-making or outcomes.
The study benchmarked high-stroke-risk patients against 40 healthy controls to contextualize the degree of hypercoagulability.
TEG was positioned as a complementary, not standalone, diagnostic tool in this setting.
What This Means
This research suggests that a specialized blood clotting test called thromboelastography (TEG) can detect an abnormally high tendency to form blood clots (hypercoagulability) in surgical patients who are considered at high risk for stroke. The study compared 220 high-stroke-risk patients to 40 healthy individuals and found that the patient group showed measurably more pro-clotting activity. Within the patient group, those who also had elevated levels of D-dimer — a protein fragment produced when blood clots break down — had an even stronger hypercoagulable profile, suggesting they may face greater clotting-related risks.
The study also found that TEG results aligned with standard blood clotting tests, meaning both approaches told a consistent story about the elevated clotting tendency in these patients. This consistency supports TEG as a potentially useful additional tool before surgery, offering a more detailed picture of how a patient's blood is clotting beyond what routine tests alone can show.
However, the authors caution that while TEG can identify this hypercoagulable state, it is not yet clear whether using TEG to guide treatment decisions actually leads to better patient outcomes. This research suggests TEG could complement existing preoperative assessments for high-stroke-risk surgical patients, but further studies are needed to determine whether acting on TEG findings improves safety or reduces complications.
Tang H, Yu W, Liang N, Hu B. (2026). Thromboelastography identifies preoperative hypercoagulability in surgical patients with high stroke risk scores: A cross-sectional study.. The Journal of international medical research. https://doi.org/10.1177/03000605261487064