C-Reactive Protein and Ferritin Are Associated With Organ Dysfunction and Mortality in Hospitalized Children. (June 2019)

• Record Type: Journal Article
• Authors: Horvat, Christopher M.; Bell, Jamie; Kantawala, Sajel; Au, Alicia K.; Clark, Robert S. B.; Carcillo, Joseph A.
• Is Part Of: Clinical pediatrics. Volume 58:Number 7(2019)
• Page Start: 752
• Page End: 760
• Publication Date: 2019-06
• Subjects: C-reactive protein -- ferritin -- learning health system -- electronic health record -- multiple organ dysfunction; Pediatrics -- Periodicals; 618.920005
• DOI: 10.1177/0009922819837352
• Languages: English
• ISSNs: 0009-9228

Abstract

Our objective was to determine if C-reactive protein (CRP) and ferritin values alone and in combination are associated with mortality among hospitalized children. All hospitalized patients at our institution with a CRP or ferritin assay in 2015 and 2016 were included. Area under the receiver operating curves (AUROC) were examined, optimal cut-points determined, and patients were stratified into low-, intermediate-, or high-risk groups based on elevation of zero, one, or both biomarkers. A total of 14 928 CRP and 653 ferritin values were obtained, with both obtained for 172 patients. AUROC for maximum CRP value was 0.76 (0.68-0.85) with a cut-point of 7.1 mg/dL for in-hospital mortality and 0.90 (0.83-0.98) for maximum ferritin with a cut-point of 373 ng/mL. Elevation of both ferritin and CRP was associated with the highest inpatient mortality (21.7%) and greatest organ dysfunction, followed by either biomarker alone. Additional prospective study of these biomarkers in combination is warranted.