Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2022.00654    [Accepted]
Published online September 16, 2022.
Ferritin in pediatric critical illness: a scoping review
Ivy Cerelia Valerie1  , Anak Agung Sagung Mirah Prabandari2  , Dyah Kanya Wati1 
1Department of Child Health, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Denpasar, Indonesia
2Mangusada General Hospital, Badung, Indonesia
Correspondence: 
Dyah Kanya Wati, Email: dyahkanyawati@unud.ac.id
Received: 6 May 2022   • Revised: 27 July 2022   • Accepted: 17 August 2022
Abstract
This scoping review aimed to elucidate and summarize the predictive role of serum ferritin in critical pediatric illness. The Preferred Reporting Items for Systematic reviews and Meta-Analyses methodology was employed to conduct a scoping review of five databases (MEDLINE, CENTRAL, ProQuest, ScienceDirect, and Epistemonikos) from the date of inception through January 24, 2022. Primary research studies involving subjects aged <18 years and serum ferritin levels were screened and reviewed independently following an a priori defined protocol. Of the 1,580 retrieved studies, 66 were analyzed. Summary statistics of serum ferritin levels for overall and condition-specific studies were reported in 30 (45.4%) and 47 (71.2%) studies, respectively. The normal range was defined in 16 studies (24.2%), whereas the threshold was determined in 43 studies (65.1%). A value of <500 ng/mL was most often the upper limit of the normal range. Serum ferritin as a numerical variable (78.9%) was usually significantly higher (80.8%) in the predicted condition than in controls, while as a categorical variable with preset thresholds, ferritin was a significant predictor in 84.6% of studies. A total of 22 predictive thresholds predicted mortality (12/46 [26.1%]), morbidity (18/46 [39.1%]), and specific (16/46 [34.8%]) outcomes in 15 unique conditions. Increased precision in serum ferritin measures followed by close attention to the threshold modeling strategy and reporting can accelerate the translation from evidence to clinical practice.
Key Words: Ferritins, Pediatric ICU, Critical illness, Clinical laboratory techniques, Hyperferritinemia


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