Ferritin levels in children with severe sepsis and septic shock.
OBJECTIVE
To evaluate serum ferritin level in children with severe sepsis and septic shock and its association with mortality.


METHODS
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.
Garcia
Pedro Celiny Ramos
PC
Pediatric 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.
Longhi
Fernanda
F
Branco
Ricardo Garcia
RG
Piva
Jefferson Pedro
JP
Lacks
Dani
D
Tasker
Robert Charles
RC
D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012306:Risk; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality
D015415:Biomarkers; D005293:Ferritins