@Article{CHD.2020.011894,
AUTHOR = {Shengwen Guo, Yuanyuan Tong, Liting Bai, Peiyao Zhang, Xin Duan, Jinping Liu},
TITLE = {Incidence, Risk Factors, and Outcomes of Hyperferritinemia after Pediatric Cardiac Surgery with Cardiopulmonary Bypass: A Retrospective Study},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {5},
PAGES = {275--285},
URL = {http://www.techscience.com/schd/v15n5/40250},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Serum ferritin has been identified as a prognostic marker in
patients with a variety of diseases. In the present study we aim to determine the
prevalence of risk factors and outcomes for hyperferritinemia in children undergoing cardiac surgery with cardiopulmonary bypass for congenital heart defects.
<b>Methods:</b> The serum ferritin levels of 457 children between the ages of twentyeight days and three years undergoing cardiopulmonary bypass surgery between
June 1, 2017 and June 1, 2018 were analyzed. The prevalence of early postoperative hyperferritinemia was investigated; hyperferritinemia was defined as a ferritin
level ≥250 ng/ml. Multivariable regression models including candidate risk
factors were constructed to determine the independent predictors of serum ferritin
levels post-bypass, analyzed as continuous variables (linear regression) and categorized variables (logistic regression). Multivariable logistic regression was
applied to assess the relationship between postoperative hyperferritinemia and a
composite of in-hospital mortality, acute kidney injury, extracorporeal life
support, prolonged postoperative hospital length of stay and prolonged postoperative mechanical ventilation. <b>Results:</b> Of the 457 included patients, frequency of
post-cardiopulmonary bypass hyperferritinemia was 59/457 (10.9%). In
multivariate logistic analyses, age [odds ratio (OR) 0.776/90 days], maximum
cardiopulmonary bypass flow [OR 1.031/(1 ml/kg)], cardiopulmonary bypass
duration (OR 1.095/10 mins) and preoperative hemoglobin [OR 1.207/(10 g/L)]
were significantly associated with early postoperative day 1 hyperferritinemia.
After risk adjustment, hyperferritinemia was independently associated with the
composite outcome (OR 6.373; 95%CI 2.863~14.184, <i>p</i> < 0.001), and improved
model discrimination, (AUC 0.868; 95%CI 0.821∼0.916) compared with basic
clinical prediction alone (AUC 0.840; 95%CI, 0.790∼0.890; △AUC = 0.0279,
<i>p</i> = 0.0218). <b>Conclusion:</b> In this study, we found early postoperative hyperferritinemia was relatively common in pediatric patients after cardiopulmonary
bypass. The occurrence of hyperferritinemia may help identify a population at risk
of unfavorable in-hospital outcome.},
DOI = {10.32604/CHD.2020.011894}
}