Zhou Zijing, Yang Deyi, Li Chan, Wu Ting, Shi Ruizheng
Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Physiol. 2023 Jul 13;14:1148891. doi: 10.3389/fphys.2023.1148891. eCollection 2023.
Serum ferritin levels are associated with a higher risk of incident heart failure (HF). Whether serum ferritin levels, either increased or decreased, predict the risk of mortality in individuals with chronic heart failure (CHF) remains unknown. This study aimed to clarify the potential predictive significance of serum ferritin levels in assessing the short-term mortality in critically ill patients with chronic heart failure (CHF). Critically ill patients with CHF were identified from the Multiparameter Intelligent Monitoring in Intensive Care III and IV (MIMIC III and IV) databases. Linear and logistic regression models and Cox proportional hazards models were applied to assess the associations between serum ferritin and survival. A total of 1,739 and 2,322 patients with CHF identified from the MIMIC III and IV databases, respectively, fulfilled the inclusion criteria. In the MIMIC III group, compared with the reference group (serum ferritin ≥70 and <500 ng/mL), serum ferritin ≥1000 ng/mL was a significant predictor of 28-day (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.14-2.72) and 90-day mortality (OR, 1.64; 95% CI, 1.13-2.39). The results from the Cox regression and Kaplan-Meier curves revealed similar results. In the MIMIC IV group, serum ferritin ≥1000 ng/mL was a significant predictor of in-hospital (OR, 1.70; 95% CI, 1.18-2.46), 28-day (OR, 1.83; 95% CI, 1.24-2.69), and 90-day mortality (OR, 1.57; 95% CI, 1.11-2.22) after adjusting for confounding factors. High ferritin levels (≥1000 ng/mL) were associated with increased short-term mortality in critically ill patients with CHF, indicating that serum ferritin may serve as a useful prognostic marker for CHF.
血清铁蛋白水平与发生心力衰竭（HF）的较高风险相关。血清铁蛋白水平无论是升高还是降低，是否能预测慢性心力衰竭（CHF）患者的死亡风险仍不清楚。本研究旨在阐明血清铁蛋白水平在评估慢性心力衰竭（CHF）危重症患者短期死亡率方面的潜在预测意义。从多参数智能重症监护III和IV（MIMIC III和IV）数据库中识别出CHF危重症患者。应用线性和逻辑回归模型以及Cox比例风险模型来评估血清铁蛋白与生存率之间的关联。分别从MIMIC III和IV数据库中识别出的1739例和2322例CHF患者符合纳入标准。在MIMIC III组中，与参考组（血清铁蛋白≥70且<500 ng/mL）相比，血清铁蛋白≥1000 ng/mL是28天（比值比[OR]，1.76；95%置信区间[CI]，1.14 - 2.72）和90天死亡率（OR，1.64；95% CI，1.13 - 2.39）的显著预测指标。Cox回归和Kaplan - Meier曲线的结果显示了相似的结果。在MIMIC IV组中，在调整混杂因素后，血清铁蛋白≥1000 ng/mL是住院（OR，1.70；95% CI，1.18 - 2.46）、28天（OR，1.83；95% CI，1.24 - 2.69）和90天死亡率（OR，1.57；95% CI，1.11 - 2.22）的显著预测指标。高铁蛋白水平（≥1000 ng/mL）与CHF危重症患者的短期死亡率增加相关，表明血清铁蛋白可能是CHF的一个有用的预后标志物。
