Assessment of Serum Ferritin Levels for Predicting the Outcome in Children Admitted with Severe Sepsis in Paediatric Intensive Care Unit in CMH Abbottabad

Khawaja Bushra Noor; Amjad Iqbal; Sumbal Pervaiz; Khushbakht Khanzada; Noor ul Huda; Maira Nazar

doi:10.70749/ijbr.v3i6.1717

Authors

Khawaja Bushra Noor Department of Paediatrics, Combined Military Hospital, Abbottabad, KP, Pakistan.
Amjad Iqbal Department of Paediatrics, Combined Military Hospital, Abbottabad, KP, Pakistan.
Sumbal Pervaiz Department of Paediatrics, Combined Military Hospital, Abbottabad, KP, Pakistan.
Khushbakht Khanzada Department of Pathology, Frontier Medical and Dental College, Abbottabad, KP, Pakistan.
Noor ul Huda Department of Paediatrics, Combined Military Hospital, Abbottabad, KP, Pakistan
Maira Nazar Department of Paediatrics, Combined Military Hospital, Abbottabad, KP, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i6.1717

Keywords:

Serum Ferritin, Severe Sepsis, Pediatric ICU, Prognostic Marker, Diagnostic Accuracy

Abstract

Background: Severe sepsis in pediatric patients remains a critical challenge in intensive care, with high morbidity and mortality rates. Identifying reliable, cost-effective prognostic markers is essential for timely risk stratification and intervention. Serum ferritin, an acute-phase reactant, has emerged as a potential predictor of adverse outcomes, though its diagnostic utility in children with sepsis requires further validation. Objective: To evaluate the diagnostic accuracy of serum ferritin in predicting adverse outcomes in pediatric patients with severe sepsis taking non survivors as gold standard. Study Design: Cross-sectional validation study. Duration and Place of Study: The study was conducted from May 2023 to December 2023 in the Paediatric Intensive Care Unit (PICU) at Combined Military Hospital, Abbottabad. Methodology: A total of 186 pediatric patients between the ages of 1 month and 12 years with confirmed severe sepsis were enrolled using consecutive non-probability sampling. Serum ferritin concentrations were assessed within the first 48 hours following admission to the pediatric intensive care unit (PICU) through a chemiluminescent immunoassay method. A threshold of 558 ng/mL or higher was applied to indicate a likelihood of adverse outcomes. Results: The average age of the participants was 5.66 ± 3.55 years, with a male-to-female ratio of 1.4:1. Out of the 186 cases, serum ferritin exhibited a sensitivity of 63.04%, specificity of 75%, positive predictive value (PPV) of 45.31%, negative predictive value (NPV) of 86.07%, and an overall diagnostic accuracy of 72.04%. Stratified analyses showed higher diagnostic performance in children ≤8 years and in those with illness duration ≤7 days. Conclusion: Serum ferritin is a moderately accurate, non-invasive prognostic biomarker for adverse outcomes in pediatric severe sepsis, particularly when integrated with clinical assessment.

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