TY - JOUR
T1 - C-Reactive Protein and Ferritin Are Associated With Organ Dysfunction and Mortality in Hospitalized Children
AU - Horvat, Christopher M.
AU - Bell, Jamie
AU - Kantawala, Sajel
AU - Au, Alicia K.
AU - Clark, Robert S.B.
AU - Carcillo, Joseph A.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by NIH Grants NICHD T32 HD40686 (CMH) and NIGMS 5R01GM108618-04 (JAC).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - 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.
AB - 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.
KW - C-reactive protein
KW - electronic health record
KW - ferritin
KW - learning health system
KW - multiple organ dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85063898339&partnerID=8YFLogxK
U2 - 10.1177/0009922819837352
DO - 10.1177/0009922819837352
M3 - Article
C2 - 30931590
AN - SCOPUS:85063898339
SN - 0009-9228
VL - 58
SP - 752
EP - 760
JO - Clinical Pediatrics
JF - Clinical Pediatrics
IS - 7
ER -