D-dimer may aid in the diagnosis of pediatric musculoskeletal infections: a prospective study.

Autor:	Topak D; Departments of Orthopaedic and Traumatology., Nazik S; Infectious Diseases., Seyithanoglu M; Biochemistry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey., Temiz A; Departments of Orthopaedic and Traumatology., Mutlu H; Departments of Orthopaedic and Traumatology., Özdemir MA; Departments of Orthopaedic and Traumatology., Doğar F; Departments of Orthopaedic and Traumatology., Bilal Ö; Departments of Orthopaedic and Traumatology.
Jazyk:	angličtina
Zdroj:	Journal of pediatric orthopedics. Part B [J Pediatr Orthop B] 2023 Jan 01; Vol. 32 (1), pp. 94-98.
DOI:	10.1097/BPB.0000000000000993
Abstrakt:	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. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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