Serum D-Dimer Concentrations Are Increased after Pediatric Traumatic Brain Injury - 24/01/15
, Janet Fromkin, MD 2, Pam Rubin, RN 2, John Snyder, BSEE 3, Rudolph Richichi, PhD 4, Patrick Kochanek, MD 1Abstract |
Objective |
To determine whether D-dimer would be increased in children with traumatic brain injury (TBI), specifically mild abusive head trauma.
Study design |
D-dimer was measured using multiplex bead technology in 195 children <4 years old (n = 93 controls without TBI, n = 102 cases with TBI) using previously collected serum. D-dimer was then measured prospectively in a clinical setting in 44 children (n = 24 controls, n = 20 cases). Receiver operator curves were generated for prospective data.
Results |
In both the retrospective and prospective cohorts, median (25th-75th percentile) D-dimer was significantly higher in cases vs controls. A receiver operator curve demonstrated an area under the curve of 0.91 (95% CI 0.83-0.99) in the prospective cohort. At a cut-off of 0.59 μg/L, the sensitivity and specificity for identification of a case was 90% and 75%, respectively.
Conclusions |
Our data suggest that serum D-dimer may be able to be used to identify which young children at risk for abusive head trauma might benefit from a head computed tomography or other additional evaluation. Additional data are needed to better identify the clinical scenarios that may result in false positive or false negative D-dimer concentrations.
Le texte complet de cet article est disponible en PDF.Keyword : AHT, AUC, CT, FDA, GCS, IRB, NPV, PPV, TBI, UPMC
Plan
| Funded by the National Institutes of Health (R01HD055986 AND 1K23HD43843 [to R.B.]) and the General Clinical Resource Center of Children's Hospital of Pittsburgh of UPMC. The authors declare no conflicts of interest. |
Vol 166 - N° 2
P. 383-388 - février 2015 Retour au numéro
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