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.