D-dimer may aid in the diagnosis of pediatric musculoskeletal infections: a prospective study.
Journal
Journal of pediatric orthopedics. Part B
ISSN: 1473-5865
Titre abrégé: J Pediatr Orthop B
Pays: United States
ID NLM: 9300904
Informations de publication
Date de publication:
01 Jan 2023
01 Jan 2023
Historique:
pubmed:
16
6
2022
medline:
16
12
2022
entrez:
15
6
2022
Statut:
ppublish
Résumé
Musculoskeletal infections, including septic arthritis, osteomyelitis, and soft tissue infections, are critical morbidity factors for children and adolescents. This study investigated the role of D-dimer levels for diagnosing childhood musculoskeletal infections. This single-center prospective study was initiated in April 2020 following approval from the local ethics committee. The study included 54 children, divided into the infection group ( n = 21), comprising patients who underwent surgical treatment for childhood musculoskeletal infections and had macroscopically visible purulent discharge during surgery, and the control group ( n = 33), comprising healthy children. In the infection group, the mean values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma D-dimer, and white blood cell (WBC) were 39.42 ± 27.00 mm/h, 101.50 ± 76.90 mg/l, 2.34 ± 2.59 mg/l, and 15.55 ± 6.86 × 10 9 /l, respectively. On comparison, the infection group showed higher levels of WBC, CRP, ESR, D-dimer, and neutrophil-to-lymphocyte ratio than the control group. When the D-dimer cutoff value of 0.43 mg/l was taken, it was observed that it had 95.2% sensitivity and 81.8% specificity. The area under curve (AUC) of the above-mentioned parameters calculated via receiver operating characteristic curves showed CRP levels as the optimum predictor of childhood musculoskeletal infections, followed by the ESR, plasma D-dimer, and WBC levels in descending order (AUC: 0.999, 0.997, 0.986, and 0.935, respectively). D-dimer is another test, which in combination with other conventional established tests (CRP and ESR) can be helpful in diagnosis of pediatric infection. We recommend the addition of D-Dimer to ESR, CRP, and WBC as a first-line investigation in cases with suspected pediatric musculoskeletal infections.
Identifiants
pubmed: 35703242
doi: 10.1097/BPB.0000000000000993
pii: 01202412-202301000-00015
doi:
Substances chimiques
fibrin fragment D
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
94-98Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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