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. 2015 Feb;166(2):383-8.
doi: 10.1016/j.jpeds.2014.10.036. Epub 2014 Nov 20.

Serum D-dimer concentrations are increased after pediatric traumatic brain injury

Rachel P Berger  1 , Janet Fromkin  2 , Pam Rubin  2 , John Snyder  3 , Rudolph Richichi  4 , Patrick Kochanek  5
Affiliations

Serum D-dimer concentrations are increased after pediatric traumatic brain injury

Rachel P Berger et al. J Pediatr. 2015 Feb.

Abstract

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Serum d-dimer concentrations in the retrospective cohort
Figure 2
Figure 2
Serum d–dimer concentrations in the prospective cohort
Figure 3
Figure 3
Received operator characteristic curve demonstrating ability to discriminate cases from controls. AUC = 0.91 (95% CI: 0.83 – 0.99)
See this image and copyright information in PMC

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