Abstract | OBJECTIVE: METHODS: We conducted a 13-month-long (2002-2003) cohort study with nested case-control in patients with sickle cell disease presenting to the pediatric ED with vaso-occlusive crises or fever in which we compared levels of secretory phospholipase A2 ( sPLA2), endothelin-1, interleukin-6 (IL-6), and peripheral white blood cell count (WBC) in cases that were complicated by ACS and in control subjects with uncomplicated illnesses. For diagnosis, a test was considered to be accurate when the area under its receiver operator characteristic curve (AUC) was >0.70. Laboratory tests with AUC values > or =0.70 were entered into a binary recursive partitioning model for diagnosis. RESULTS: For the period of study, samples from 72 visits were obtained from 51 patients who presented with vaso-occlusive crises (range: 1-4 visits per patient; 15 were enrolled more than once). ACS complicated 19 of 72 visits (26%, 95% confidence interval: 17%-38%). At an AUC value of 0.79, only the sPLA2 test was accurate for diagnosing ACS. AUC values for peripheral WBC, endothelin-1, and IL-6 were 0.68, 0.51, and 0.52, respectively. Binary recursive partitioning retained only sPLA2 at a cutoff of 13.7 ng/mL to be accurate for diagnosis. This cutoff had a sensitivity of 74% (14 of 19), a specificity of 87% (46 of 53), a positive likelihood ratio of 5.6, and a negative likelihood ratio of 0.18. CONCLUSIONS:
|
Authors | James T Naprawa, Bema K Bonsu, Deborah G Goodman, Mark A Ranalli |
Journal | Pediatrics
(Pediatrics)
Vol. 116
Issue 3
Pg. e420-5
(Sep 2005)
ISSN: 1098-4275 [Electronic] United States |
PMID | 16099851
(Publication Type: Journal Article)
|
Chemical References |
- Biomarkers
- Endothelin-1
- Interleukin-6
- Phospholipases A
- Phospholipases A2
|
Topics |
- Acute Disease
- Adolescent
- Anemia, Sickle Cell
(blood, complications)
- Area Under Curve
- Biomarkers
(blood)
- Chest Pain
- Child
- Endothelin-1
(blood)
- Female
- Humans
- Interleukin-6
- Leukocyte Count
- Lung Diseases
(blood, diagnosis, etiology)
- Male
- Phospholipases A
(blood)
- Phospholipases A2
- Sensitivity and Specificity
- Syndrome
|