The clinical significance of D-dimer for prediction of traumatic brain injury in children

【Objective】 To investigate whether plasma D-dimer levels could replace head CT to predict the traumatic brain injury(TBI) of children or not.【Methods】 A prospective cohort observational study was conducted of 116 children with traumatic brain injury between Jan 2006 and Mar 2010 from the pediatric traumatic center of our hospital.At the time of initial evaluation,blood was obtained to measure electrolytes,coagulation makers,complete blood count.The general data were recorded from the data bank of our center.The related statistical analysis was done to evaluate the predictive value of appropriate biomarkers for traumatic brain injury instead of head CT.【Results】 Plasma levels of D-dimer were associated with TBI on head CT by univariate analysis(P 0.01).It was an independent predictor for TBI instead of head CT and stronger than the baseline Glasgow Coma Scale(P =0.08).AD-dimer level cut-off 500 pg/μL had 94% negative predictive value(P 0.01) for brain injury on head CT.Other makers including prothrombin time,partial thromboplastin time and so on were not.【Conclusions】 In children who meet clinical criteria for a head CT scan after trauma,low plasma D-dimer suggests the absence of significant brain injury.