Plasma D-dimer safely reduces unnecessary CT scans obtained in the evaluation of pediatric head trauma
| Autor: | Hari Thangarajah, Stephen W. Bickler, Timothy J. Fairbanks, Erin Ward, Katherine P. Davenport, Simone Langness, Karen Kling, Radhames E. Lizardo, Jonathan Halbach, Julia Grabowski |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Traumatic brain injury Population Head trauma Fibrin Fibrinogen Degradation Products 03 medical and health sciences 0302 clinical medicine Skull fracture D-dimer Craniocerebral Trauma Humans Medicine 030212 general & internal medicine Child education Retrospective Studies education.field_of_study Trauma Severity Indices Skull Fractures business.industry Head injury Infant Newborn Infant Diagnostic algorithms General Medicine medicine.disease nervous system diseases Child Preschool Pediatrics Perinatology and Child Health Biomarker (medicine) Female Surgery Radiology Tomography X-Ray Computed business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Journal of Pediatric Surgery. 53:752-757 |
| ISSN: | 0022-3468 |
| Popis: | Serum D-dimer has been proposed as a biomarker to aid in the diagnosis of pediatric traumatic brain injury (TBI). We investigated the accuracy of D-dimer in predicting the absence of TBI and evaluated the degree by which D-dimer could limit unnecessary computed tomography scans of the head (CTH).Retrospective review of patients with suspected TBI from 2011 to 2013 who underwent evaluation with CTH and quantitative D-dimer. D-dimer levels were compared among patients with clinically-important TBI (ciTBI), TBI, isolated skull fracture and no injury.Of the 663 patients evaluated for suspected TBI, ciTBI was identified in 116 (17.5%), TBI in 77 (11.6%), skull fracture in 61 (9.2%) and no head injury in 409 (61.7%). Patients with no head injury had significantly lower D-dimer values (1531±1791pg/μL) compared to those with skull fracture, TBI and ciTBI (2504±1769, 2870±1633 and 4059±1287pg/μL, respectively, p0.005). Using a D-dimer value750pg/μL as a negative screen, no ciTBIs would be missed and 209 CTHs avoided (39.7% of total).Low plasma D-dimer predicts the absence of ciTBI for pediatric patient with suspected TBI. Incorporating D-dimer into current diagnostic algorithms may significantly limit the number of unnecessary CTHs performed in this population.Study of diagnostic test.I. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect