C-Reactive Protein and Ferritin Are Associated With Organ Dysfunction and Mortality in Hospitalized Children

Christopher M. Horvat, Jamie Bell, Sajel Kantawala, Alicia K. Au, Robert S.B. Clark, Joseph A. Carcillo

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

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.

Original languageEnglish
Pages (from-to)752-760
Number of pages9
JournalClinical Pediatrics
Volume58
Issue number7
DOIs
StatePublished - Jun 1 2019

Keywords

  • C-reactive protein
  • electronic health record
  • ferritin
  • learning health system
  • multiple organ dysfunction

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