Ferritin levels in children with severe sepsis and septic shock

• Published in: Acta Paediatrica Vol. 96; no. 12; pp. 1829 - 1831
• Main Authors: Garcia, Pedro Celiny Ramos, Longhi, Fernanda, Branco, Ricardo Garcia, Piva, Jefferson Pedro, Lacks, Dani, Tasker, Robert Charles
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2007; Blackwell
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Biomarkers - blood; Child; Child, Preschool; Children; Cohort Studies; Emergency and intensive care: infection, septic shock; Female; Ferritin; Ferritins - blood; General aspects; Human bacterial diseases; Humans; Infant; Infectious diseases; Intensive care; Intensive care medicine; Iron metabolism; Male; Medical sciences; Prognosis; Prospective Studies; Regression Analysis; Risk; ROC Curve; Sepsis; Sepsis - blood; Sepsis - mortality; Shock, Septic - blood; Shock, Septic - mortality; Human; Pediatrics; Intensive care; Iron metabolism; Prognosis; Ferritin; Septic shock; Iron; Metabolism; Inorganic element; Bacteremia; Infection; Sepsis syndrome; Bacteriosis; Sepsis; Children; Severe; Child
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2007.00564.x

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.