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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 2  |  Page : 101-103

D-dimer: A useful marker in neonatal sepsis


1 Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
2 Department of Mathematics, Rajkiya Kanya Maha Vidyalaya, Shimla, Himachal Pradesh, India

Correspondence Address:
Dr. Pancham Kumar
Department of Pediatrics, Indira Gandhi Medical College, Shimla - 171 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.154552

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Objectives: To measure D-dimer levels in neonatal sepsis and compare D-dimer as a marker of sepsis with the gold standard that is, 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: Prospective observational hospital based study. Setting: Tertiary care hospital. Subjects: From November 2010 to October 2011, 936 neonates were admitted to the neonatal unit of Indira Gandhi Medical College, Shimla, Himachal Pradesh. Out of these, 355 neonates were admitted with suspected sepsis. Out of these, only 101 term neonates were without asphyxia and blood culture positive and were enrolled as cases, and 96 term neonates without the asphyxia admitted for neonatal jaundice without sepsis were enrolled as controls. Methods: All neonates, cases and control were investigated as per the protocol at admission and simultaneously the D-dimer levels were measured. D-dimer levels were evaluated in predicting neonatal sepsis and were compared with other established markers of sepsis in predicting sepsis. Results: In the study group, age ranged from 0 to 22 days with an average of 5.58 days. In the control group, age ranged from 0 to 23 days with an average of 5.62 days. Sex distribution was almost equal in both groups. The mean value of D-dimer in the cases and control group were 1.832 mg% and 1.365 mg% respectively. The study group had significantly higher values of D-dimer (P - 0.04). Sensitivity and negative predictive value of D-dimer in predicting sepsis were 90.0% and 84.4% respectively, the highest amongst all the markers studied in sepsis. Positive predictive value and specificity of TLC in sepsis was highest in all the marker studied. Negative predictive value of various markers was comparable in sepsis. Conclusion: D-dimer is a sensitive predictor of sepsis in neonates with a high sensitivity and negative predictive value. Hence, it should be included in the septic screening of newborns.


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