C-Reactive Protein and Ferritin Are Associated With Organ Dysfunction and Mortality in Hospitalized Children

Area of Science:

• Biomarkers in Pediatric Hospitalization
• Clinical Pathology
• Pediatric Critical Care Medicine

Background:

• C-reactive protein (CRP) and ferritin are inflammatory markers.
• Their role in predicting mortality in hospitalized children requires further investigation.

Purpose of the Study:

• To assess the association of C-reactive protein (CRP) and ferritin levels, individually and combined, with mortality in hospitalized children.
• To determine optimal cut-points for these biomarkers to stratify mortality risk.

Main Methods:

• Retrospective analysis of hospitalized patients from 2015-2016 with CRP or ferritin assays.
• Calculation of Area Under the Receiver Operating Curves (AUROC) to evaluate predictive accuracy.
• Stratification of patients into risk groups based on biomarker elevation.

Main Results:

• Maximum CRP value (cut-point 7.1 mg/dL) had an AUROC of 0.76 for in-hospital mortality.
• Maximum ferritin value (cut-point 373 ng/mL) had an AUROC of 0.90 for in-hospital mortality.
• Combined elevation of both CRP and ferritin was associated with the highest inpatient mortality (21.7%) and organ dysfunction.

Conclusions:

• Elevated CRP and ferritin levels are associated with increased mortality in hospitalized children.
• The combination of both biomarkers demonstrates significant predictive value for mortality.
• Further prospective studies are recommended to validate these findings.