Open AccessPredictive value of iron parameters in neurocritically ill patients
Author(s) -
Xie Ling,
Peng Yu,
Huang Kaibin,
Wu Yongming,
Wang Shengnan
Publication year - 2018
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.1163
Subject(s) - medicine , modified rankin scale , logistic regression , univariate analysis , multivariate analysis , renal function , intensive care unit , retrospective cohort study , ischemic stroke , ischemia
Abstract Background Iron, an essential mineral for human body, has the potential to cause toxicity at high levels. Previous studies have shown inconsistent predictive value of iron parameters in critically ill patients. Thus, we aimed to evaluate the performance of iron parameters in outcome prediction of neurocritically ill patients. Methods Retrospective data were collected from patients admitted to the neurocritical care unit (NCU) of a tertiary teaching hospital between August 2016 and January 2017. The iron parameters were obtained at NCU admission. Primary endpoints were short‐term (30‐day) mortality and long‐term (6‐month) poor outcome, with the latter defined as modified Rankin Scale of 4–6. The predictive value of variables was determined with univariate and multivariate logistic analysis. A further subanalysis was conducted in patients stratified by the level of estimated glomerular filtration rate (eGFR). Results Of 103 eligible patients, the etiology included stroke (58.2%, N = 60), central nervous system infection (13.6%, N = 14), and other neurologic disorders (28.2%, N = 29). The correlation analysis showed that the increase in ferritin, as well as the reduction in transferrin and total iron‐binding capacity, had strong correlation with C‐reactive protein, procalcitonin, duration of NCU stay, Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score. In a further subanalysis of 75 patients with eGFR ≥ 60 ml/min/1.73 m 2 , twelve (16.0%) patients died within 30 days and 39 (52.0%) patients achieved good follow‐up outcome data. In the multivariate logistic regression analysis, we identified baseline ferritin level as an independent predictor of short‐term mortality (OR: 1.002; 95% CI: 1.000–1.003; p = 0.008) and long‐term functional outcome (OR: 1.002; 95% CI: 1.000–1.004; p = 0.031). Conclusions Serum ferritin level at admission could be used as an independent predictor of short‐term mortality and long‐term functional outcome in neurocritically ill patients with eGFR ≥ 60 ml/min/1.73 m 2 .