Ferritin-based biomarkers and their prognostic value in Vietnamese patients with sepsis.

Abstract

Introduction: Sepsis remains a critical global health challenge because of its high mortality rates and complex pathophysiology. Early and accurate diagnosis and prognosis is pivotal for enhancing clinical outcomes in sepsis management. This study investigates the prognostic implications of serum ferritin, the ferritin index (FI), and the ferritin to lymphocyte ratio (FLR) on septic shock and 28-day mortality among Vietnamese patients with sepsis.

Methods: We conducted a retrospective cohort analysis using data from medical records of 89 patients with sepsis.

Results: The study establishes FI and procalcitonin cutoffs for discriminating septic shock at 2.29 and 37.15 µg/mL, respectively, with sensitivities of 71.9% and 54.4% and specificities of 56.3% and 77.4%, respectively. Combining FI and procalcitonin enhances predictive capability. Predicting 28-day mortality, serum ferritin, FLR, and Sequential Organ Failure Assessment scores have cutoffs of 828.45 µg/L, 901.41 mg/G, and 10.5, respectively, with varying sensitivities and specificities. Integration of serum ferritin value and FLR with Sequential Organ Failure Assessment score substantially improves predictive accuracy (area under the curve approaching 0.8). Subgroup analysis revealed pronounced associations, particularly serum ferritin, with acute kidney injury (odds ratio = 10.00) and anemia (odds ratio = 11.27) in predicting mortality.

Discussion: This study underscores FLR's novel mortality prediction utility and reinforces ferritin biomarkers' prognostic relevance in sepsis, highlighting implications for tailored sepsis management strategies.