Abstract：
OBJECTIVE: To investigate characteristics and outcomes of critically ill cancer patients with marked hyperferritinemia.
METHODS: A single-center retrospective analysis comprising cancer patients with a ferritin level >10.000 μg/L treated in the intensive care unit (ICU) between 2012 and 2022 was conducted.
RESULTS: A total of 117 patients were included in the analysis. The median age was 59 years (range: 15-86 years). Females accounted for 48% of cases. 90% of patients had a hematologic malignancy. The median maximum ferritin level was 27.349 μg/L (range: 10.300-426.073 μg/L). The diagnostic criteria of septic shock were fulfilled in 51% of cases; 31% of patients had hemophagocytic lymphohistiocytosis (HLH) according to the HLH-2004 criteria. Mechanical ventilation, renal replacement therapy and the use of vasopressors were necessary in 59%, 35% and 70% of cases, respectively. The ICU, hospital, 90-day and 1-year survival rates were 33.3%, 23.1%, 23.7% and 11.7%. Patients with septic shock had a worse survival than those without septic shock (p = .001); the survival of patients who fulfilled the HLH-2004 criteria did not differ from those who did not (p = .88).
CONCLUSIONS: Critically ill cancer patients with marked hyperferritinemia have poor outcomes. The present data may help to make informed decisions for this patient group.
METHODS: A single-center retrospective analysis comprising cancer patients with a ferritin level >10.000 μg/L treated in the intensive care unit (ICU) between 2012 and 2022 was conducted.
RESULTS: A total of 117 patients were included in the analysis. The median age was 59 years (range: 15-86 years). Females accounted for 48% of cases. 90% of patients had a hematologic malignancy. The median maximum ferritin level was 27.349 μg/L (range: 10.300-426.073 μg/L). The diagnostic criteria of septic shock were fulfilled in 51% of cases; 31% of patients had hemophagocytic lymphohistiocytosis (HLH) according to the HLH-2004 criteria. Mechanical ventilation, renal replacement therapy and the use of vasopressors were necessary in 59%, 35% and 70% of cases, respectively. The ICU, hospital, 90-day and 1-year survival rates were 33.3%, 23.1%, 23.7% and 11.7%. Patients with septic shock had a worse survival than those without septic shock (p = .001); the survival of patients who fulfilled the HLH-2004 criteria did not differ from those who did not (p = .88).
CONCLUSIONS: Critically ill cancer patients with marked hyperferritinemia have poor outcomes. The present data may help to make informed decisions for this patient group.
摘要：
目的：探讨伴有显著高铁蛋白血症的危重癌症患者的特点及转归。
方法：进行了一项单中心回顾性分析，包括2012年至2022年在重症监护病房（ICU）治疗的铁蛋白水平>10.000μg/L的癌症患者。
结果：共117例患者纳入分析。中位年龄为59岁（范围：15-86岁）。女性占病例的48%。90％的患者患有恶性血液病。最大铁蛋白水平中位数为27.349μg/L（范围：10.300-426.073μg/L）。51％的病例符合感染性休克的诊断标准；根据HLH-2004标准，31％的患者患有噬血细胞性淋巴组织细胞增生症（HLH）。机械通气,59%的人需要肾脏替代治疗和使用血管加压药，35%和70%的病例，分别。ICU,医院,90天和1年生存率为33.3％，23.1%,23.7%和11.7%。脓毒性休克患者的生存率比没有脓毒性休克的患者差（p=.001）；符合HLH-2004标准的患者的生存率与未符合HLH-2004标准的患者的生存率没有差异（p=.88）。
结论：患有显著高铁蛋白血症的危重癌症患者的预后较差。当前数据可能有助于为该患者组做出明智的决定。
方法：进行了一项单中心回顾性分析，包括2012年至2022年在重症监护病房（ICU）治疗的铁蛋白水平>10.000μg/L的癌症患者。
结果：共117例患者纳入分析。中位年龄为59岁（范围：15-86岁）。女性占病例的48%。90％的患者患有恶性血液病。最大铁蛋白水平中位数为27.349μg/L（范围：10.300-426.073μg/L）。51％的病例符合感染性休克的诊断标准；根据HLH-2004标准，31％的患者患有噬血细胞性淋巴组织细胞增生症（HLH）。机械通气,59%的人需要肾脏替代治疗和使用血管加压药，35%和70%的病例，分别。ICU,医院,90天和1年生存率为33.3％，23.1%,23.7%和11.7%。脓毒性休克患者的生存率比没有脓毒性休克的患者差（p=.001）；符合HLH-2004标准的患者的生存率与未符合HLH-2004标准的患者的生存率没有差异（p=.88）。
结论：患有显著高铁蛋白血症的危重癌症患者的预后较差。当前数据可能有助于为该患者组做出明智的决定。
