ABSTRACT
Introduction: Coagulation tests performed in laboratory are prothrombin time, activated partial thromboplastin time (APTT),thrombin time help in understanding of pathways involved in coagulation, yet they lack information on the complexity of haemostasis.Global coagulation assays like Thromboelastogram, Thrombin Generation Test and Clot waveform analysis (CWA) are point of caretests which provide rapid approach to a clinical condition. Clot waveis an optical waveform which measures changes in transmittance orabsorbance of light beam through sample. Various applications ofCWA have been extensively studied in last few years.Aims &Objectives: To analyze clot wave form characteristics likemorphology, first and second derivative values in cases with abnormalAPTT.Materials &Methods: APTT and curves generated by ACL TOP300 analyzer of total 125 patients and 20 controls were included.Parameters studied were first derivative (maximum velocity of clotformation), second derivatives (maximum acceleration and deceleration), morphology of curve: sigmoid, biphasic, prolonged precoagulation phase, second derivative morphology like early and lateshoulder, biphasic peak, delayed deceleration were noted. MannWhitney U test was performed and p value was determined.Result: The APTT waveforms were analyzed in 125 patients (M: F-2.2:1, mean age: 46.9 ± 20 years). A spectrum of clinical conditionsshowed covid (20%), liver disease (23%), polytrauma (10.4%), cardiac (8.8%), sepsis/DIC (7.2%), thromboembolism (7.2%), renal(6.4%), bacterial infections (4%), dengue (4%), snake bite (1.6%),factor deficiency (1.6%). There was significant difference in acceleration and deceleration peaks in cases of liver and heart disease,sepsis, dengue, polytrauma and sepsis/DIC cases. Deceleration peakwas additionally prolonged in patients of covid (p<0.05). Firstderivative peak was prolonged in only sepsis and liver diseases(p< 0.05). The pre coagulation phase was prolonged in 75 cases(60%) cases and predominantly covid patients along with secondderivative showing delayed deceleration, early and late shoulder.Conclusions: CWA is readily available on automated coagulationanalyzers being inexpensive with fast turn round time. It providesboth quantitative information on coagulation like velocity, acceleration of clot formation and qualitative details of wave pattern. Therewas significant association of second derivative with the disease inour study. Our study highlights importance to probe into quantitativeand qualitative CWA parameters acquired by performing a simpleAPTT test.