Abstract：
BACKGROUND: Ferritin is an iron deposition protein and a commonly ordered clinical test. While high levels may signify iron deposition, the majority are due to metabolic, inflammatory, infectious, and malignant disorders. The association between ferritin elevations < 1000 μg/L and long-term mortality is well demonstrated. The association between extreme ferritin elevations, namely ferritin levels over 10,000 μg/L, and short-term mortality, as well as predictors of mortality, has not been defined.
METHODS: A retrospective chart study was designed in an academic hospital to analyze the clinical, laboratory, and mortality characteristics of patients whose ferritin is over 10,000 μg/L. Patients from 2012 to 2023 in a large academic center\'s electronic medical records were analyzed. Demographics, underlying disorders, laboratory values, mortality status, and days to mortality were acquired. Multivariate logistic regression analysis was used to define predictors of mortality. The Kaplan-Meier survival curve was used to analyze survival.
RESULTS: Sixty-seven patients were identified to have ferritin levels over 10,000 μg/L. The most common underlying disorders were infectious diseases and malignancies. Predictors of mortality in the multivariate logistic regression model were also infectious disease (odds ratio (OR) = 5.35), and malignancy (OR = 6.56), as well as age (OR = 1.05). The area under the curve of the model was .86. 1-year mortality was 62%. Of the patients who died, median survival was 5 days; 30- and 90-day mortality were 80% and 92%, respectively.
CONCLUSIONS: Extreme hyperferritinemia is associated with high short-term mortality. Ferritin can be used as a marker of poor prognosis, particularly among patients with infection and malignancy.
METHODS: A retrospective chart study was designed in an academic hospital to analyze the clinical, laboratory, and mortality characteristics of patients whose ferritin is over 10,000 μg/L. Patients from 2012 to 2023 in a large academic center\'s electronic medical records were analyzed. Demographics, underlying disorders, laboratory values, mortality status, and days to mortality were acquired. Multivariate logistic regression analysis was used to define predictors of mortality. The Kaplan-Meier survival curve was used to analyze survival.
RESULTS: Sixty-seven patients were identified to have ferritin levels over 10,000 μg/L. The most common underlying disorders were infectious diseases and malignancies. Predictors of mortality in the multivariate logistic regression model were also infectious disease (odds ratio (OR) = 5.35), and malignancy (OR = 6.56), as well as age (OR = 1.05). The area under the curve of the model was .86. 1-year mortality was 62%. Of the patients who died, median survival was 5 days; 30- and 90-day mortality were 80% and 92%, respectively.
CONCLUSIONS: Extreme hyperferritinemia is associated with high short-term mortality. Ferritin can be used as a marker of poor prognosis, particularly among patients with infection and malignancy.
摘要：
背景：铁蛋白是一种铁沉积蛋白，是一种常用的临床测试。虽然高水平可能意味着铁沉积，大部分是由于新陈代谢，炎症，传染性,和恶性疾病。铁蛋白升高<1000μg/L与长期死亡率之间的关联得到了很好的证明。极端铁蛋白升高之间的关联，即铁蛋白水平超过10,000μg/L，和短期死亡率，以及死亡率的预测因素，尚未定义。
方法：在一家学术医院设计了一项回顾性图表研究，以分析临床，实验室,和铁蛋白超过10,000μg/L的患者的死亡率特征。分析了2012年至2023年在大型学术中心的电子病历中的患者。人口统计,潜在的疾病，实验室值，死亡率状况,获得了死亡的天数。多因素logistic回归分析用于确定死亡率的预测因子。采用Kaplan-Meier生存曲线进行生存分析。
结果：67例患者的铁蛋白水平超过10,000μg/L最常见的基础疾病是感染性疾病和恶性肿瘤。多变量逻辑回归模型中死亡率的预测因素也是传染病（比值比（OR）=5.35），恶性肿瘤（OR=6.56），以及年龄（OR=1.05）。模型曲线下面积为.86。1年死亡率为62%。在死去的病人中，中位生存期为5天；30天和90天死亡率分别为80%和92%，分别。
结论：极端高铁蛋白血症与高短期死亡率相关。铁蛋白可作为预后不良的标志物,特别是在感染和恶性肿瘤患者中。
方法：在一家学术医院设计了一项回顾性图表研究，以分析临床，实验室,和铁蛋白超过10,000μg/L的患者的死亡率特征。分析了2012年至2023年在大型学术中心的电子病历中的患者。人口统计,潜在的疾病，实验室值，死亡率状况,获得了死亡的天数。多因素logistic回归分析用于确定死亡率的预测因子。采用Kaplan-Meier生存曲线进行生存分析。
结果：67例患者的铁蛋白水平超过10,000μg/L最常见的基础疾病是感染性疾病和恶性肿瘤。多变量逻辑回归模型中死亡率的预测因素也是传染病（比值比（OR）=5.35），恶性肿瘤（OR=6.56），以及年龄（OR=1.05）。模型曲线下面积为.86。1年死亡率为62%。在死去的病人中，中位生存期为5天；30天和90天死亡率分别为80%和92%，分别。
结论：极端高铁蛋白血症与高短期死亡率相关。铁蛋白可作为预后不良的标志物,特别是在感染和恶性肿瘤患者中。
