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Clinical and prognostic significance of elevated ferritin levels in hospitalised adults
  1. Ariel Israel1,
  2. Gil Bornstein2,
  3. Lee Gilad3,
  4. Liran Shechtman3,
  5. Nadav Furie3,
  6. Ilan Ben-Zvi3,
  7. Chagai Grossman3
  1. 1Department of Family Medicine, Clalit Health Services, Tel Aviv, Israel
  2. 2Department of Internal Medicine B, Tel Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv, Israel
  3. 3Department of Internal Medicine F, Sheba Medical Center at Tel Hashomer, affilated to Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  1. Correspondence to Dr Chagai Grossman, Sheba Medical Center, Tel Hashomer, Israel; chagaigr{at}gmail.com

Abstract

Purpose of the study Elevated ferritin levels are associated with a variety of infectious, malignant and inflammatory diseases. We aimed to investigate the prognostic value of markedly elevated ferritin levels in hospitalised patients with various medical conditions.

Study design Retrospective analysis of patients with a ferritin level higher than 2000 ng/mL hospitalised in Sheba Medical Center between 1 January 2007 and 31 December 2015. Medical conditions of these patients were recorded. In-hospital, 30-day and 1-year mortality rates were evaluated according to ferritin ranges and clinical categories.

Results The study included 722 patients (63.4% men) with a mean age of 63.9±16.7 years. The most common clinical conditions associated with markedly elevated ferritin were infectious diseases and malignancies. The highest mean ferritin levels were associated with rheumatological/inflammatory conditions (16 241.3 ng/dL), particularly in patients with macrophage activation syndrome (MAS) (96 615.5 ng/dL). In-hospital, 30-day and 1-year mortality rates were 32.3%, 46.7% and 70.8%, respectively. The highest in-hospital, 30-day and 1-year mortality rates were observed among patients with solid malignancies (40.1%, 64.7% and 90.3%, respectively), whereas the lowest rates were found among patients with rheumatological/inflammatory conditions, including MAS (21.4%, 38.1% and 45.2%, respectively). Ferritin levels were not associated with mortality.

Conclusions In hospitalised patients, ferritin levels higher than 2000 ng/mL are mainly associated with infectious and malignant diseases but do not predict mortality.

  • rheumatology

Data availability statement

Data are available on reasonable request. Deidentified participant data.

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Data availability statement

Data are available on reasonable request. Deidentified participant data.

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Footnotes

  • AI and GB are joint first authors.

  • AI and GB contributed equally.

  • Contributors AI, GB and CG planned the conducted the study. LG extracted the data from the medical records. LS submitted the study. NF and AI analysed the findings of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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