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Ferritin levels in children with severe sepsis and septic shock
Pedro Celiny Ramos Garcia1, Fernanda Longhi, Ricardo Garcia Branco
1Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, and Medical School, Pontifica Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Insights
In children with severe sepsis or septic shock, elevated serum ferritin levels are linked to a higher risk of death. Specifically, ferritin over 500 ng/mL significantly increases mortality risk.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Severe sepsis and septic shock are life-threatening conditions in children.
- Serum ferritin is an iron-storage protein that can be elevated during inflammation.
Purpose of the Study:
- To investigate serum ferritin levels in pediatric severe sepsis and septic shock.
- To determine the association between ferritin levels and mortality in these critically ill children.
Main Methods:
- A cohort study included 36 children (1 month-16 years) with severe sepsis or septic shock.
- Serum ferritin levels were measured at diagnosis, and a ferritin index (FI) was calculated.
- Statistical analysis, including logistic regression, was used to assess associations with mortality.
Main Results:
- Children with ferritin levels >500 ng/mL had a 3.2-fold increased risk of death (p=0.01).
- A ferritin index (FI) of 1.7 was identified as the optimal cutoff for predicting mortality.
- Both ferritin levels and the Pediatric Risk of Mortality (PRISM) score were independent predictors of mortality.
Conclusions:
- Elevated serum ferritin is common in children with severe sepsis and septic shock.
- High ferritin levels are significantly associated with poorer outcomes and increased mortality in this pediatric population.
Aim:
To evaluate serum ferritin level in children with severe sepsis and septic shock and its association with mortality.
Method:
A cohort study of 36 children aged 1 month-16 years with severe sepsis or septic shock requiring intensive care was conducted. Serum ferritin levels were measured at the time of diagnosis of sepsis and a ferritin index (FI=observed serum ferritin divided by the upper limit of normal ferritin for age and gender) was calculated.
Results:
The median age (range) of the children was 6 (2-100) months. Ferritin was <200 ng/mL in 13 children, 200-500 ng/mL in 11 children and >500 ng/mL in 12 children. The mortality associated with these groups was 23%, 9% and 58%, respectively. A ferritin>500 ng/mL was associated with a 3.2 (1.3-7.9) relative risk of death (p=0.01). FI of 1.7 was the best cutoff value for identifying those who died. In a logistic regression analysis, ferritin level and PRISM were independently associated with mortality.
Conclusions:
Ferritin is raised in children with septic shock and high ferritin level is associated with poorer outcome.
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