D-DIMER AS A MARKER FOR PEDIATRIC TRAUMATIC BRAIN INJURY IN RELATION TO THE TIME OF LABORATORY ACQUISITION | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 8, Volume 24, Issue 4, October 2021, Page 2488-2504 PDF (283.04 K) | ||||
| Document Type: Original Article | ||||
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| Abstract | ||||
| Background: Traumatic brain injury (TBI) is one of the main causes of pediatric deaths and disability worldwide. Biomarkers for TBI could have many potential uses regarding quick diagnostic testing for proper and early management. Serum D-dimer has been proposed as a biomarker to aid in the diagnosis of brain injury in pediatric head trauma. Aim of the work: Evaluate the accuracy of D-Dimer as a marker of brain injury in pediatric patients with head trauma in relation to time of lab acquisition. Patients and methods: This is a prospective study carried out during the period from January 2019 to July 2021 on 40 children with TBI have been admitted to El Hussein university hospital - Al-Azhar University. The candidates were sequentially enrolled in the study then classified into three groups; Group I (mild cases) represented with 10 patients with head trauma without significant brain injury (no neuroimaging finding e.g., skull fracture, brain contusion or laceration, intra cerebral hemorrhage, subarachnoid hemorrhage, intra ventricular hemorrhage, extradural or subdural hematoma etc.) and their GCS was ≥ 13, Group II (moderate cases) represented with 21 patients had significant traumatic brain injury in neuroimaging and their GCS was >8 and Group III (severe cases) represented with 9 patients had significant traumatic brain injury in neuroimaging and their GCS was ≤8. Quantitative D-dimer was evaluated at 6, 12 and 24 hours of the head trauma. All candidates aged (> 1 m to ≤ 18 y) old, with isolated head trauma and referred to hospital within 6 hours from the onset of trauma were included in the study. Any patient with chronic neurological disease (e.g., ADEMS, CP, etc.), previous brain injuries, coagulopathy, anticoagulants administration, poly trauma patient and (neurosurgical intervention or died) before first blood sample were excluded from the study. Results: There was statistically significant difference between the studied groups regarding D-dimer values versus the severity of trauma at 6 h, 12 h (P | ||||
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