Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No.161 Shaoshan South Road, Changsha, 410004, Hunan, China.
Sci Rep. 2023 May 29;13(1):8677. doi: 10.1038/s41598-023-35874-2.
This study aimed to investigate the relationship between serum ferritin level and prognosis in sepsis. It also explored the potential prognostic value of serum ferritin for predicting outcomes in sepsis based on a large public database. Sepsis patients in MIMIC-IV database were included. Different models including crude model (adjusted for none), model I (adjusted for age and gender) and model II (adjusted for all potential confounders) were performed. Smooth fitting curves were constructed for exploring the relationships between serum ferritin and mortalities of 28-day, 90-day, 180-day and 1-year. Receiver operator characteristic (ROC) curve analysis was utilized for assessing the predictive value of serum ferritin. 1947 sepsis patients were included. The mortalities of 28-day, 90-day, 180-day and 1-year were 20.18% (n = 393), 28.35% (n = 552), 30.30% (n = 590) and 31.54% (n = 614), respectively. In Model II (adjusted for all potential confounders), for every 1000 ng/ml increment in serum ferritin, the values of OR in mortalities of in 28-day, 90-day, 180-day and 1-year were 1.13 (95% CI 1.07-1.19, P < 0.0001), 1.15 (95% CI 1.09-1.21, P < 0.0001), 1.16 (95% CI 1.10-1.22, P < 0.0001) and 1.17 (95% CI 1.10-1.23, P < 0.0001), respectively. The relationships between serum ferritin level and outcomes were non-linear. The areas under the ROC curve (AUC) of ferritin for predicting mortalities of 28-day, 90-day, 180-day and 1-year were 0.597 (95% CI 0.563-0.629), 0.593 (95% CI 0.564-0.621), 0.595 (95% CI 0.567-0.623) and 0.592 (95% CI 0.564-0.620), respectively. The non-linear relationships between serum ferritin and clinical outcomes in sepsis were found. Serum ferritin had a predictive value for short-term and long-term outcomes in sepsis.
本研究旨在探讨血清铁蛋白水平与脓毒症预后之间的关系。并基于大型公共数据库，探讨血清铁蛋白预测脓毒症结局的潜在预后价值。纳入 MIMIC-IV 数据库中的脓毒症患者。分别构建了未校正（调整年龄和性别）、模型 I（调整所有潜在混杂因素）和模型 II（调整所有潜在混杂因素）的不同模型。构建了血清铁蛋白与 28 天、90 天、180 天和 1 年死亡率之间的关系的平滑拟合曲线。采用受试者工作特征（ROC）曲线分析评估血清铁蛋白的预测价值。共纳入 1947 例脓毒症患者。28 天、90 天、180 天和 1 年的死亡率分别为 20.18%（n=393）、28.35%（n=552）、30.30%（n=590）和 31.54%（n=614）。在模型 II（调整所有潜在混杂因素）中，血清铁蛋白每增加 1000ng/ml，28 天、90 天、180 天和 1 年死亡率的 OR 值分别为 1.13（95%CI 1.07-1.19，P<0.0001）、1.15（95%CI 1.09-1.21，P<0.0001）、1.16（95%CI 1.10-1.22，P<0.0001）和 1.17（95%CI 1.10-1.23，P<0.0001）。血清铁蛋白水平与结局之间呈非线性关系。铁蛋白预测 28 天、90 天、180 天和 1 年死亡率的 ROC 曲线下面积（AUC）分别为 0.597（95%CI 0.563-0.629）、0.593（95%CI 0.564-0.621）、0.595（95%CI 0.567-0.623）和 0.592（95%CI 0.564-0.620）。在脓毒症中发现了血清铁蛋白与临床结局之间的非线性关系。血清铁蛋白对脓毒症的短期和长期结局具有预测价值。
