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Retrospective analysis of ferritin, outcome and HLH-criteria in critically ill patients.
The study is a retrospective register study of critically ill patients from Charité - Universitätsmedizin Berlin during 2000 and 2016 that had at least one measurement of plasma ferritin. Outcome, underlying diagnoses and HLH-2004 criteria (Henter JI et al. 2007) will be analyzed and the HScore of these patients will be calculated (Fardet L et al. 2014). All recorded data of the specific admission term in ICU will be used for the analysis. No follow-up of the patients after discharge will be performed in this study. The study does not involve any randomization or any drug testing.
Update 2019: We expanded our database for the years until 2018 and also for the surgical and medical ICUs of the Charité - Universitätsmedizin Berlin (from 256 to 2623 patients).
Update 2022: A systematic literature search will be performed to find suitable validation cohorts for multicenter validation of optimized HLH diagnostic criteria, which are calculated based on our data (new secondary endpoint).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Critically ill patients | Male and female critically ill patients admitted to the Charité - University Medicine Berlin during 2000 and 2018. |
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| Measure | Description | Time Frame |
|---|---|---|
| Mortality | A retrospective analysis of patients with available charts to determine the outcome whether patients survived the ICU or died. | Participants will be followed up for the duration of hospital stay, an expected average of two months |
| Probability of having undiagnosed Hemophagocytic lymphohistiocytosis (HLH) | Retrospective analysis of available charts, underlying diagnoses, findings and blood values: HLH-2004 criteria (Henter JI et al. 2007) and HScore (Fardet L et al. 2014) | The participants will be followed up for the duration of hospital stay, an expected average of two months |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnoses | Retrospective analysis of available charts and underlying diagnoses | Participants will be followed up for the duration of hospital stay, an expected average of two months |
| Intensive care unit stay |
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Inclusion Criteria:
Exclusion Criteria:
-age below 18 years
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Male and female critically ill patients admitted to the Charité - Universitätsmedizin Berlin during 2000 and 2018
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| Name | Affiliation | Role |
|---|---|---|
| Gunnar Lachmann, MD | Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Operative Intensive Care Medicine | Study Director |
| Gunnar Lachmann, MD | Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Operative Intensive Care Medicine | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16937360 | Background | Henter JI, Horne A, Arico M, Egeler RM, Filipovich AH, Imashuku S, Ladisch S, McClain K, Webb D, Winiarski J, Janka G. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2007 Feb;48(2):124-31. doi: 10.1002/pbc.21039. | |
| 24782338 | Background | Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, Coppo P, Hejblum G. Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome. Arthritis Rheumatol. 2014 Sep;66(9):2613-20. doi: 10.1002/art.38690. |
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| ID | Term |
|---|---|
| D051359 | Lymphohistiocytosis, Hemophagocytic |
| D055501 | Macrophage Activation Syndrome |
| D004194 | Disease |
| ID | Term |
|---|---|
| D015616 | Histiocytosis, Non-Langerhans-Cell |
| D015614 | Histiocytosis |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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Retrospective analysis of available charts and duration of ICU stay
| Participants will be followed up for the duration of intensive care unit stay, an expected average of one week |
| Improving HLH diagnostic criteria including multicenter validation | Sensitivity and specificity of HLH diagnostic criteria should be improved by calculating different cutoffs of HLH-2004 criteria. Combinations with highest sensitivity and specificity will be validated in published cohorts of HLH testing for sensitivity and specificity. | Participants will be followed up for the duration of intensive care unit stay, an expected average of one week |
| 34252125 | Derived | Knaak C, Schuster FS, Nyvlt P, Heeren P, Spies C, Schenk T, La Rosee P, Janka G, Brunkhorst FM, Lachmann G. Influence of transfusions, hemodialysis and extracorporeal life support on hyperferritinemia in critically ill patients. PLoS One. 2021 Jul 12;16(7):e0254345. doi: 10.1371/journal.pone.0254345. eCollection 2021. |
| 32448380 | Derived | Knaak C, Nyvlt P, Schuster FS, Spies C, Heeren P, Schenk T, Balzer F, La Rosee P, Janka G, Brunkhorst FM, Keh D, Lachmann G. Hemophagocytic lymphohistiocytosis in critically ill patients: diagnostic reliability of HLH-2004 criteria and HScore. Crit Care. 2020 May 24;24(1):244. doi: 10.1186/s13054-020-02941-3. |
| 31626037 | Derived | Knaak C, Schuster FS, Spies C, Vorderwulbecke G, Nyvlt P, Schenk T, Balzer F, La Rosee P, Janka G, Brunkhorst FM, Keh D, Lachmann G. Hemophagocytic Lymphohistiocytosis in Critically Ill Patients. Shock. 2020 Jun;53(6):701-709. doi: 10.1097/SHK.0000000000001454. |
| 30010630 | Derived | Lachmann G, Spies C, Schenk T, Brunkhorst FM, Balzer F, La Rosee P. Hemophagocytic Lymphohistiocytosis: Potentially Underdiagnosed in Intensive Care Units. Shock. 2018 Aug;50(2):149-155. doi: 10.1097/SHK.0000000000001048. |
| D008232 | Lymphoproliferative Disorders |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |