THE EFFECT OF SERUM FERRITIN LEVEL ON MORTALITY AND MORBIDITY IN CRITICAL CARE PATIENTS ADMITTED TO EMERGENCY DEPARTMENT

Project no. 32007 · Status: Kapanmış (Yayın bekleniyor) · 2024

Summary

Objective: The aim of this study is to investigate the effect of serum ferritin levels on mortality and morbidity (intubation, inotropic support, major cardiac events, need for thrombolytics) in critically ill patients admitted to the emergency department. This study aims to evaluate the prognostic significance of serum ferritin levels in critically ill patients in greater detail. Materials and Methods: In this study, ferritin samples were collected from patients admitted to the critical care unit of the Emergency Department of Ege University between January 2024 and June 2024, with patient consent, and analyzed in the Biochemistry Laboratory. The patients' files were reviewed, and a comprehensive database was created for prospective analysis. During their follow-up in the emergency department, the patients' diagnoses, vital signs (systolic blood pressure, diastolic blood pressure, heart rate, temperature, respiratory rate, oxygen saturation), blood gas values (pH, HCO3, pCO2, lactate), serum ferritin levels, hemoglobin levels, white blood cell count, neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio, GGT, albumin, CRP, and procalcitonin levels were evaluated along with patient outcomes, including 48-hour and 1-month mortality and morbidity (intubation, need for inotropes, major cardiac events, need for thrombolytics). Results: A total of 500 patients were included in the study. The distribution of diseases upon admission to the emergency department showed that 214 (33.9%) patients had cardiac-related diagnoses, 197 (31.2%) had pulmonary-related diagnoses, 88 (13.9%) had cranial-related diagnoses, and 133 (21%) had other diagnoses. It was found that patients with high ferritin levels had a higher incidence of sepsis, pneumonia, acute kidney failure, and urinary tract infections, and these patients had worse prognoses. The 48-hour and 1-month mortality rates in the emergency department and the respective wards were 21 (4.2%) and 97 (19.4%). The differences in serum ferritin levels between patients with and without 48-hour mortality were not statistically significant. However, the median serum ferritin level of patients who died within the first month was 450 µg/L, which was statistically higher. According to ROC analysis, the performance of ferritin levels in predicting mortality, particularly 1-month mortality, was found to have high sensitivity and specificity. 18.9% of surviving patients and 57.7% of deceased patients had ferritin levels above 300 µg/L. Significant positive correlations were found between ferritin levels and gamma-glutamyl transferase (GGT), CRP, and procalcitonin, while a negative correlation was found with albumin.Conclusion: This study demonstrates that ferritin is not only a biomarker for iron storage but also an important marker associated with pathophysiological processes such as inflammation, oxidative stress, and tissue damage. Serum ferritin levels have been shown to be a strong biomarker for predicting the prognosis of critically ill patients, with high levels being particularly associated with mortality and severe morbidity. These findings highlight the importance of routine monitoring of ferritin levels in emergency and intensive care units for the early recognition and intervention of critically ill patients. Keywords: ferritin, critically ill patient, emergency department, mortality

View details