Routine ferritin levels tied to high mortality risk in hospitalized patients

In hospitalized patients, routine ferritin concentrations upon admission show a linear and independent association with an increased risk of mortality, even among those with “normal” ferritin concentrations (<300 mg/mL), suggests a recent study.

"Thus, low-grade ferritinemia might not be an innocent finding in the context of the inflammatory response,” the investigators said. “Its potential biological and therapeutic implications warrant future research.”

In this study, investigators collected routine ferritin measurements taken within 24 hours of admission in 2,859 patients hospitalized in an internal medicine department. They then examined the association between ferritin and overall mortality during a median follow-up of 15 months using multiple clinical and laboratory parameters.

Ferritin concentrations significantly correlated with increased 30-day mortality rates (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 1.03−1.06) for each 100-ng/mL increase. Patients with high (>221 ng/mL) and intermediate (78−220 ng/mL) ferritin levels had greater rates of mortality at 30 days (OR, 2.05, 95 percent CI, 1.70−2.5) even after adjusting for age, sex, and comorbidities.

Additionally, a similar pattern for long-term overall mortality rates (hazard ratio, 1.54, 95 percent CI, 1.39−1.71) was observed across ferritin tertiles.

“Serum ferritin is usually measured in the presence of anaemia or in suspected iron overload syndromes,” the investigators said. “Ferritin is also an acute-phase protein that is elevated during systemic inflammation.”