Abstract | OBJECTIVE: DESIGN: Retrospective observational study. SETTING: Adult surgical, anesthesiologic, and medical ICUs of a university hospital. PATIENTS:
Critical care patients (≥ 18 yr old) admitted to any of the adult ICUs at Charité - Universitätsmedizin Berlin between January 2006 and August 2018 with at least one ferritin value and hyperferritinemia (≥ 500 µg/L). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were categorized into hemophagocytic lymphohistiocytosis, sepsis, septic shock, and other diagnoses. These were further categorized into 17 subgroups. Hemophagocytic lymphohistiocytosis diagnosis was based on Hemophagocytic Lymphohistiocytosis-2004 criteria and the HScore. Of 2,623 patients with hyperferritinemia, 40 were considered to have hemophagocytic lymphohistiocytosis (1.52%). Maximum ferritin levels were highest in hemophagocytic lymphohistiocytosis patients compared with all other disease groups (each p < 0.001). Sepsis and septic shock patients had higher maximum ferritin levels than patients with other diagnoses (each p < 0.001). A maximum ferritin value of 9,083 µg/L was at 92.5% sensitivity and 91.9% specificity for hemophagocytic lymphohistiocytosis (area under the curve, 0.963; 95% CI, 0.949-0.978). Of all subgroups with other diagnoses, maximum ferritin levels were highest in patients with varicella-zoster virus, hepatitis, or malaria (median, 1,935, 1,928, and 1,587 µg/L, respectively). Maximum ferritin levels were associated with increased in-hospital mortality (odds ratio, 1.518 per log µg/L [95% CI, 1.384-1.665 per log µg/L]; p < 0.001). CONCLUSIONS:
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Authors | Gunnar Lachmann, Cornelia Knaak, Gerald Vorderwülbecke, Paul La Rosée, Felix Balzer, Thomas Schenk, Friederike S Schuster, Peter Nyvlt, Gritta Janka, Frank M Brunkhorst, Didier Keh, Claudia Spies |
Journal | Critical care medicine
(Crit Care Med)
Vol. 48
Issue 4
Pg. 459-465
(04 2020)
ISSN: 1530-0293 [Electronic] United States |
PMID | 32205591
(Publication Type: Journal Article, Observational Study)
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Chemical References |
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Topics |
- Adult
- Age Factors
- Biomarkers
(blood)
- Critical Illness
(epidemiology)
- Female
- Ferritins
(blood)
- Germany
- Humans
- Hyperferritinemia
(blood, diagnosis, epidemiology)
- Intensive Care Units
- Lymphohistiocytosis, Hemophagocytic
(blood, diagnosis, epidemiology)
- Male
- Middle Aged
- Retrospective Studies
- Sepsis
(blood, diagnosis, epidemiology)
- Young Adult
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