Association between serum ferritin levels and sepsis severity and clinical outcomes in children with sepsis: a prospective observational study.

Ashwini Kurtakoti; Laxminarayan; Shivakumar N Hadli

doi:10.51168/9nq0qc33

Authors

Ashwini Kurtakoti Senior Resident, Department of Paediatrics, Karawar Institute of Medical Sciences, Karwar, Pin code 581301
Dr. Laxminarayan Senior Resident, Department of Radiology, St. John's Medical College and Hospital, Bangalore
Dr.Shivakumar N Hadli Assistant Professor, Department of General Surgery, Karwar Institute of Medical Sciences, Karwar

DOI:

https://doi.org/10.51168/9nq0qc33

Keywords:

Pediatric sepsis, Serum ferritin, Biomarker, Multiple organ dysfunction syndrome, Septic shock, Prognosis, Total leukocyte count, Platelet count

Abstract

Background:

Sepsis remains a major cause of morbidity and mortality among children worldwide. Early identification of disease severity using reliable biomarkers is essential for timely intervention and improved outcomes.

Objectives:

To evaluate the association between serum ferritin levels and the severity of pediatric sepsis and to assess its relationship with clinical outcomes, including multiple organ dysfunction syndrome (MODS), recovery, and mortality.

Methods:

This prospective observational study was conducted in the Pediatric Intensive Care Unit of a tertiary care teaching hospital and included 50 children aged 1 month to 12 years diagnosed with sepsis. Serum ferritin levels were measured during sepsis, septic shock, MODS, and on the seventh day of recovery. Statistical analyses were performed to determine associations between serum ferritin, disease severity, and patient outcomes, with p<0.05 considered statistically significant.

Results:

The mean age of participants was 2.73±2.35 years, with equal representation of males and females. Mortality was 12%, while 88% recovered. Mean serum ferritin levels increased progressively from sepsis (501.88 ng/L) to septic shock (620.00 ng/L) and MODS (1716.67 ng/L), followed by a marked decline during recovery (131.70 ng/L), indicating a close association with disease severity. However, serum ferritin did not demonstrate a statistically significant association with mortality. Lower leukocyte and platelet counts were significantly associated with adverse outcomes, whereas hemoglobin and C-reactive protein were not significantly associated with mortality.

Conclusions:

Serum ferritin is a valuable biomarker for assessing disease severity and monitoring the clinical course of pediatric sepsis, although it may not independently predict mortality. Total leukocyte and platelet counts demonstrated greater prognostic significance for adverse outcomes.

Recommendation

Given the results of the present study, serum ferritin could be regarded as an adjunct biomarker for the evaluation of sepsis severity and prognosis in children in addition to clinical evaluation and routine laboratory tests.

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