Work

Diagnostic value of systemic inflammation markers in differentiating complicated and simple parapneumonic effusions in children

Year: 2025

Type: article

Abstract: Purpose: Parapneumonic effusion (PPE) is one of the major complications of pediatric pneumonia. We aimed to evaluate the diagnostic performance of systemic inflammatory biomarkers in distinguishing between simple and complicated PPE and to determine whether these markers could serve as reliable, rapid, and noninvasive tools in clinical decisionmaking for this complication.Methods: This retrospective study included pediatric patients aged 3 months-18 years diagnosed with pneumonia and confirmed to have PPE by ultrasonography from January 1, 2012 through August 1, 2024. Patients with sepsis or comorbidities associated with PPE were excluded. The study population was classified into simple < 1 cm, simple ≥ 1 cm, and complicated PPE groups based on initial ultrasonography findings. Among the groups, we compared inflammatory markers including white blood cells, absolute neutrophil count, absolute lymphocyte count, absolute monocyte count, platelets, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, lymphocyteto-monocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index.Results: Among the total of 200 pediatric patients with PPE, both mean symptom duration and hospital length of stay were longest in the complicated PPE group. Pleural fluid cultures were positive in 7 patients, most commonly isolating Streptococcus pyogenes. Compared with the simple < 1 cm group, the complicated PPE group showed higher mean values of white blood cells, absolute neutrophil count, ESR, CRP, systemic immune-inflammation index, and systemic inflammation response index. Receiver operating characteristic curves showed fair performances of ESR (area under the curve, 0.73) and CRP (0.72) for predicting the presence of complicated PPE.Conclusion: Systemic inflammatory indices, particularly ESR and CRP, demonstrated potential value in distinguishing complicated PPE from simple one in pediatric patients. These readily available markers may assist clinicians in early risk stratification and decision-making regarding invasive procedures.

Source: Pediatric Emergency Medicine Journal

DOI: 10.22470/pemj.2025.01382

Authors: Ceren Akdag, Hurs¸it Apa

Institutions: Dr. Behçet Uz Çocuk Hastalıkları Hastanesi, Sağlık Bilimleri Üniversitesi

Language: English

Topic: Pleural and Pulmonary Diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $200