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All Journal Medicina E-Jurnal Medika Udayana Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) Bali Journal of Anesthesiology Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education ISM (Intisari Sains Medis) : Jurnal Kedokteran Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Journal of Public Health and Pharmacy Jurnal Kedokteran Meditek Jurnal ARSI : Administrasi Rumah Sakit Indonesia
Dyah Kanya Wati
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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Association of sepsis severity with serum ferritin in the pediatric intensive care unit Susanto, Yohanes; Wati, Dyah Kanya; Artana, I Wayan Dharma; Wati, Ketut Dewi Kumara; Widnyana, Anak Agung Ngurah Ketut Putra; Adnyana, I Gusti Agung Ngurah Sugitha
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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Abstract

Background Sepsis remains a leading cause of pediatric intensive care unit (PICU) admissions in Indonesia. Serum ferritin is a potential biomarker for sepsis severity that requires validation. Objective To evaluate the association between serum ferritin and sepsis severity in children. Methods In this cross-sectional study, we consecutively enrolled children with sepsis (aged 1 month to 18 years) with lactate-excluded PELOD-2 scores of ≥7 admitted to the PICU of a tertiary referral hospital. Severe sepsis was defined as a PELOD-2 score of ≥11. Serum ferritin levels were measured at the time of PELOD-2 assessment. We determined the optimal ferritin cut-off point for severe sepsis by ROC analysis and performed bivariate and multivariate analyses to assess the association of ferritin level with sepsis severity. Results Among 74 subjects, 48.6% had severe sepsis. Serum ferritin concentration showed excellent discriminative power for severe vs. non-severe sepsis, with an area under curve (AUC) of 80% (95%CI 69.7-90.4%; P<0.001). The optimal serum ferritin cut-off level was 1,473.88 ng/mL, with a sensitivity of 80.6% and specificity of 78.9%. Severe sepsis was strongly correlated with elevated ferritin [bivariate prevalence ratio (PR) 3.8 (95%CI 2.0 to 8.2; P<0.001); adjusted PR 3.9 (95%CI 1.7 to 8.6; P=0.001)]. Conclusion Serum ferritin may serve as a biomarker for severe sepsis in children with good discriminative performance and may be useful for risk stratification of pediatric sepsis.
Co-Authors Abdul Latief Abdul Latief Adnyana, I Gusti Agung Ngurah Sugitha Anak Agung Ngurah Ketut Putra Widnyana Andreliano Yosua Rompis Andy Halim Anlidya Permatasari Gunawijaya Antonius Pudjiadi Antonius Pudjiadi Artini, Ni Wayan Noni Arya Krisna Manggala Aurelya, Anira Rema Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana BNP Arhana Cempaka, Putu Mas Vina Paramitha Clearesta, Kartika Eda Defranky Theodorus Derryl Komala Putra Desak Made Widiastiti Arga Dewi Sutriani Mahalini Djoko, Sri Wahyuni Eka Gunawijaya Estina, Vania Catleya Fajaryani, Putu Ayu Putri Felicia Anita Wijaya Gusti Ayu Nyoman Yulia Sitta Dewi Haning, Joy Aprianis Harsika Sari, Ni Wayan Diah Intan I Gde Doddy Kurnia Indrawan I Gede Deden Susma Sugara I Gede Wikania Wira Wiguna I Gusti Ayu Putu Eka Pratiwi I Gusti Ayu Sri Darmayani I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Made Bakta I Made Jawi I Made Kardana I Made Karma Setiyawan I Nengah Gandi Karyadi I Nyoman Budi Hartawan I NYOMAN MANTIK ASTAWA I Wayan Darma Artana I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma I Wayan Gustawan Ida Bagus Gede Suparyatha Ida Bagus Subanada Jumantini, Ni Komang Pasek Nurhyang Ketut Dewi Kumara Wati Ketut Suarta Ketut Suarta Suarta Ketut Tuti Parwati Merati Ketut Wulan Ari Kartika Ardhaputri Khema Metta Wijaya Komang Ayu Witarini Komang Diah Kurnia Kesumaputri Komang Diah Kurnia Kesumaputri Luh Putu Diah Virayanti Luh Putu Putri Sanjiwani Made Gede Dwi Lingga Utama Made Gede Dwi Lingga Utama Made Michel Kresnayasa Made Pande Lilik Lestari Made Sukmawati Made Wiryana Manggala, Arya Krisna Maria Elisabeth Sylvinna Wasi Elannor Maria Pricilla Siboe Nelvina Ginting Ni Luh Sri Apsari Ni Made Ary Sarasmita Ni Putu Siadi Purniti Novita Purnamasari Assa Nyoman Gina Henny Kristianti Pande Made Nova Armita Sari, Pande Made Nova Putri, Ni Kadek Dwi Pramana Putu Andrie Setiawan Putu Aryani Putu Diah Pratiwi Putu Diah Pratiwi Putu Indah Budi Apsari Putu Nandika Tungga Yudanti Mahardani Putu Nandika Tungga Yudanti Mahardani Putu Nandika Tungga Yudanti Mahardani Retayasa Retayasa Ryan Tan Silvia Sudarmadji Siska Permanasari Sinardja Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sukarta, Ni Kadek Yusthiani Suparyatha, Ida Bagus Gede Susanto, Yohanes Sutriani Mahalini, Dewi Visakha Karuna Wijaya Wayan Sulaksmana Sandhi Parwata