D-DIMER AS AN EARLY DIAGNOSTIC MARKER IN NEONATES WITH SEPSIS | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 3, Volume 25, Issue 1, January 2022, Page 2412-2427 PDF (169.67 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2022.247415 | ||||
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| Abstract | ||||
| ABSTRACT Objectives: To measure D.dimer levels in neonatal sepsis and compare as a marker of sepsis with blood culture and other established marker of sepsis like C.reactive protein, micro. erythrocyte sedimentation rate and total leucocyte count (TLC) in predicting sepsis. Study Design: A case control hospital based study. Subjects: From September 2020 till March 2021. 90 patients with neonatal sepsis selected from neonatal units of Bab-Elsheria university hospital. They were divided in to 3 groups Early onset sepsis (EOS) group (Group A) that include 30 neonates, Late onset sepsis (LOS) group (Group B) that include 30 neonates and control group (Group C) that include 30 healthy neonates. Methods: All neonates, cases and control were investigated at admission. A complete medical history, clinical examination, and diagnostic tests were performed for all newborns (CBC, CRP, blood culture, D-dimer) and simultaneously the D‑dimer levels were evaluated in predicting neonatal sepsis and were compared with other established markers of sepsis in predicting sepsis. Results: In the current study, there was no statistical significant difference between groups as regard sex and Residence, but there was statistical significant difference between groups as regard Weight (kg) and Age (day) where p < 0.05, p < 0.001 respectively. Group A (Early onset sepsis) included 8 (26.7%) with Negative blood culture and 22(73.3%) had Positive blood culture, Group B (Late onset sepsis) included 3(10%) with Negative blood culture and 27(90%) had Positive blood culture, Group C (control group) included 30 (100 %) with Negative blood culture. There was statistical significant difference between studied groups as regard D dimer and TLC where p < 0.05, also as regard Micro ESR and CRP where p < 0.001.From the results of this study, D-dimer has highly statistical significant ability to diagnose septic neonates with sensitivity 70.0%, specificity 60.0%, PPV 77.8%, and NPV 50.0%, as regard CRP; sensitivity was 98.33%, specificity was 100.0%, PPV was100.0%,and NPV is 96.8% to diagnose neonatal sepsis, then as regard Micro-ESR highly statistical significant ability to diagnose neonatal sepsis with sensitivity is 78.33%, specificity is 76.67%, PPV is 87.0%, NPP is 63.9%, and TLC at cut of value >11780 has highly statistical significant ability to diagnose neonatal sepsis with sensitivity is 66.67%, specificity is 63.33%, PPV is 78.4%, NPP is 48.7%. D-dimer had the lowest specificity and positive predictive value of 60% and 77.8% respectively amongst the markers studied. Conclusion: Although D-dimer was inferior to CRP&TLC&ESR in predicting neonatal sepsis, it should be measured in neonates with sepsis for early identification of DIC. | ||||
| Keywords | ||||
| D.dimer; sepsis; screen | ||||
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