Serum Ferritin and Clinical Outcomes in Children Undergoing Pediatric Cardiac Surgery

Background: Hyperferritinemia is a prognostic marker in critical illness, but its role in postoperative outcomes of pediatric congenital heart defects remains poorly defined, especially in resource-limited settings. This study evaluated early serum ferritin as a predictor of outcomes after congenital heart surgery and its association with the Pediatric Index of Mortality ۳ (PIM ۳) score.Methods: A single-center prospective cohort study was conducted from April ۲۰۲۳ to October ۲۰۲۴ at a tertiary referral center in southeastern Brazil. Patients aged ۲۹ days to ۱۸ years, of both sexes, admitted to the pediatric intensive care unit (PICU) after congenital heart surgery were included and categorized according to the presence of cyanotic or acyanotic heart disease. Group comparisons were performed using Fisher’s exact test, chi-square test, Student’s t-test, ANOVA, or Kruskal–Wallis test, with statistical significance set at p < ۰.۰۵.Results: A total of ۱۰۵ patients were included. Median ferritin was higher in patients with PICU stays < ۷ days (۱۸۳ ng/mL; p = ۰.۰۰۴) and was significantly associated with a PIM ۳ score ≥ ۵% (۶۴۲ ng/mL; p < ۰.۰۰۶). Cyanotic patients had longer PICU stays (۱۱.۰ vs. ۷.۲ days; p = ۰.۰۲), longer use of vasoactive drugs (۳.۸ vs. ۲.۶ days; p = ۰.۰۱), and accounted for all deaths (p < ۰.۰۰۱). Hemoglobin and hematocrit were also significantly higher in cyanotic patients (۱۴ vs. ۱۳ g/dL and ۴۰% vs. ۳۷%; p < ۰.۰۰۱).Conclusions: Serum ferritin may serve as a marker of secondary outcomes and aid early risk stratification in congenital heart defect patients in the PICU.

کلیدواژه ها:

Congenital ، Heart Defects ، hyperferritinemia ، Intensive Care Units ، Mortality ، outcomes ، Pediatric