Is d-dimer associated with disease severity and contralateral slip risk in slipped capital femoral epiphysis?

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dc.authorid0000-0001-8956-3819
dc.authorid0000-0002-8427-8856
dc.authorid0000-0002-5570-9493
dc.authorid0000-0002-8562-217X
dc.authorid0000-0002-0702-289X
dc.contributor.authorKürk, Muhammed Bilal
dc.contributor.authorAlbayrak, Kutalmış
dc.contributor.authorAydın, Abdurrahman
dc.contributor.authorKayış, Görkem
dc.contributor.authorAkpınar, Evren
dc.date.accessioned2026-08-26T14:44:48Z
dc.date.available2026-08-26T14:44:48Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractBackground: To evaluate D-dimer levels in patients with slipped capital femoral epiphysis (SCFE), to investigate their associa tion with disease severity and the development of contralateral slip, and to assess their contribution to existing predictive models. Methods: In this single-center retrospective cohort study, 25 patients with unilateral SCFE diagnosed between January 2020 and April 2024 were included. The control group con sisted of age- and sex-matched obese individuals and healthy subjects with normal body mass index (BMI). Clinical varia bles (age, sex, BMI, stability according to the Loder classi fication, and chronicity); laboratory parameters [complete blood count, neutrophil-to-lymphocyte ratio (NLR), in flammatory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and coagulation pa rameters including prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer]; and radiographic measurements [Southwick angle, interhip angle difference, posterior sloping angle (PSA), and modified Oxford bone score (MOBS)] were analyzed. Subgroup analyses based on stability and chronicity were performed, and correlations between D-dimer levels and clinical, laboratory, and radio graphic parameters were assessed. Multivariable logistic re gression models were constructed to predict contralateral slip, and model performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: D-dimer levels were significantly higher in the SCFE group compared with both obese and healthy control groups (P < 0.001). D-dimer showed positive correlations with CRP and NLR and negative correlations with the MOBS and the interhip Southwick angle difference. Higher D-dimer levels were ob served in unstable and acute-on-chronic cases (P < 0.001). During a mean follow-up of 24 months, patients who developed contralateral slip had significantly higher D-dimer levels (P = 0.002). The addition of Southwick angle difference to a baseline model including age and MOBS increased the AUC from 0.73 to 0.80, while further inclusion of D-dimer improved the AUC to 0.87. However, the increase in AUC after addition of D-dimer was not statistically significant according to the paired DeLong test (P = 0.18). Conclusion: D-dimer levels are associated with disease severity and the risk of contralateral slip in SCFE. Incorporation of D-dimer into established clinical and radiographic parameters improved predictive model performance. These findings support the role of inflammatory and microvascular processes in the pathogenesis of SCFE and suggest that D-dimer may serve as a useful adjunct biomarker for risk stratification.
dc.identifier.citationKürk, M. B., Albayrak, K., Aydın, A., Kayış, G., & Akpınar, E. (2026). Is d-dimer associated with disease severity and contralateral slip risk in slipped capital femoral epiphysis?. Journal of Pediatric Orthopaedics, pp. 1-7. https://doi.org/10.1097/BPO.0000000000003441
dc.identifier.doi10.1097/BPO.0000000000003441
dc.identifier.endpage7
dc.identifier.issn0271-6798
dc.identifier.issn1539-2570
dc.identifier.pmidPMID: 42579393
dc.identifier.scopus2-s2.0-105047637685
dc.identifier.scopusqualityQ2
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1097/BPO.0000000000003441
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1615
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorAkpınar, Evren
dc.institutionauthorid0000-0002-0702-289X
dc.language.isoen
dc.publisherWolters Kluwer
dc.relation.ispartofJournal of Pediatric Orthopaedics
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectSlipped Capital Femoral Epiphysis
dc.subjectD-Dimer
dc.subjectContralateral Slip
dc.subjectRisk Prediction
dc.subjectInflammation
dc.subjectCoagulation
dc.titleIs d-dimer associated with disease severity and contralateral slip risk in slipped capital femoral epiphysis?
dc.typeArticle
dspace.entity.typePublication

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