D-dimer: The Risk Factor and Predictive Indicator of Necrotizing Pneumonia in Children.

BACKGROUND: Necrotizing pneumonia (NP) is a severe complication of community-acquired pneumonia in children. This article assesses the risk factors and the diagnostic value of D-dimer for NP in children. METHODS: The selected patients with lobar pneumonia were divided into two groups, namely: the NP group and the pneumonia only group. This article conducted a comparative study in the differences between the two groups. The authors identified the independent factors of NP with the assistance of multivariate logistic regression analysis upon the completion of the univariate analysis. The authors applied the receiver operating characteristic (ROC) curve for the purpose of discovering the indicators with the most predictive abilities of NP. RESULTS: Three risk factors were observed to be independently associated with the development of NP: Total duration of fever (OR 1.406, 95% CI 1.264 - 1.834), WBC counts (OR 2.662, 95% CI 1.592 - 3.981), and D-dimer (OR 2.878, 95% CI 1.671 - 4.902). D-dimer levels present with higher accuracy in terms of predicting the development of NP than the other two, with a value that is under the ROC of 0.886 (95% CI, 0.815 - 0.958). CONCLUSIONS: Significantly higher D-dimer levels are observed in children with NP. D-dimer could be considered as one of the most important risk factors and predictive indicators of NP.