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Keywords:

  • Children;
  • Ferritin;
  • Intensive care;
  • Iron metabolism;
  • Prognosis;
  • Sepsis

Abstract

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.