GIÁ TRỊ NỒNG ĐỘ FERRITIN HUYẾT THANH TRONG TIÊN ĐOÁN SỐT XUẤT HUYẾT DENGUE NẶNG Ở TRẺ EM TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ NĂM 2024-2025

Abstract

Background: The identification of predictive factors for severe dengue (SD) is of paramount importance for effective disease management and therapeutic interventions. While serum ferritin, alongside other established clinical and laboratory biomarkers, has been hypothesized to play a significant role in assessing SD severity, its specific predictive value in pediatric populations warrants more thorough investigation. Objectives: To describe the demographic, clinical, and laboratory characteristics in pediatric Dengue patients and to determine the predictive value of serum ferritin, including its sensitivity, specificity, and cut-off threshold, in predicting severe Dengue in children. Materials and methods: A prospective diagnostic test study was conducted on 104 children diagnosed with Dengue admitted to Can Tho Children's Hospital from May 2024 to March 2025. A univariate logistic regression model was employed to identify laboratory parameters associated with disease severity, and Receiver Operating Characteristic (ROC) curves were used to assess the predictive value of ferritin in severe Dengue. Results: A total of 104 SD patients were included in the analysis, comprising 22 severe SD cases and 82 non-severe SD cases. The median age was 7 years (IQR: 4–11). Serum ferritin levels (ng/mL) were significantly higher in the SD group compared to the non-severe SD group: for day 1 (D1), 194 (84.3–612.8) vs. 5277.7 (2752.8–6029.3), and for day 3 (D3), 183.8 (98.7–541.2) vs. 2176 (1416.2–3817). At a cut-off of 1443 ng/mL, ferritin demonstrated 91% sensitivity and 86.6% specificity, with an area under the curve (AUC) of 0.946 for D1 and 0.967 for D3. The 870 ng/mL threshold yielded 100% sensitivity and 87.8% specificity. Conclusion: This study suggests that serum ferritin is a valuable predictive biomarker for assessing SD in pediatric patients.