Evidence map›Paper›PMID 40906216›Full record

Observational studyInflammation research : official journal of the European Histamine Research Society ... [et al.]2025

Early hyperferritinemia in polytrauma: a biomarker of systemic inflammation and mortality risk in a multicenter cohort study.

Shunyao Chen, Teding Chang, Jialiu Luo, Cong Zhang, Peidong Zhang, Shuaipeng Gu, Zhiqiang Lin, Yujie Chen, Youxie Shen, Liming Dong and 12 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Inflammation research : official journal of the European Histamine Research Society ... [et al.], 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Shunyao ChenDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Teding ChangDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Jialiu LuoDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Cong ZhangDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Peidong ZhangDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Shuaipeng GuDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Zhiqiang LinDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Yujie ChenDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Youxie ShenDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Liming DongDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Qian WanDepartment of Trauma Surgery, Trauma Center, Xiantao First People's Hospital, Xiantao, 433000, China.
Liang HeDepartment of Trauma Surgery, Trauma Center, Xiantao First People's Hospital, Xiantao, 433000, China.
Yu LeiDepartment of Trauma Surgery, Trauma Center, Xiantao First People's Hospital, Xiantao, 433000, China.
Zhibiao ZhangDepartment of Emergengcy, Trauma Center, Yingcheng People's Hospital, Yingcheng, 432400, China.
Kewen CaoDepartment of Emergengcy, Trauma Center, Yingcheng People's Hospital, Yingcheng, 432400, China.
Jiaying LinDepartment of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Di XuDepartment of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Xiaozhong ZhouDepartment of Emergency Medicine, Trauma Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China.
Zengxiang YangDepartment of Emergency Medicine, Trauma Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China.
Deng ChenDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. chendeng@tjh.tjmu.edu.cn.
Chunqiu PanDepartment of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. pcqi@smu.edu.cn.
Zhao-Hui TangDepartment of Trauma Surgery, Emergency Surgery and Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. tangzh@tjh.tjmu.edu.cn.

Funding

Hubei Province health and family planning scientific research project WJ2023M015National Natural Science Foundation of China 81873870(Z-HT)
6 · The paper itself

Abstract

backgroundSevere polytrauma is one of the leading causes of death and disability worldwide. Hyperferritinemia is increasingly recognized as a biomarker of critical illness, yet its prognostic significance in polytrauma remains underexplored. This multicenter study investigates the temporal dynamics of serum ferritin in polytrauma patients and its association with systemic inflammation, organ dysfunction, and mortality.

methodsA prospective observational cohort of 1475 polytrauma patients from four trauma centers was analyzed. Serum ferritin levels were measured on admission day 1 and day 7. Patients were stratified by ferritin thresholds: < 500 ng/ml, 500-999 ng/ml, 1000-2999 ng/ml, and ≥ 3000 ng/ml. Outcomes included mortality, ICU stay, complications, and organ dysfunction. Logistic regression and ROC analyses identified predictive thresholds. A prognostic nomogram integrating Day 1 ferritin, ferritin change (ΔFerritin), inflammatory markers (IL-6, CRP), and clinical scores (SOFA, APACHE II) was developed and internally validated.

resultsHyperferritinemia (≥ 500 ng/mL) occurred in 39.3% of patients, with mortality escalating from 9.2% (ferritin < 500) to 66.7% (ferritin ≥ 3000) (P < 0.001). Day 7 ferritin (> 655 ng/mL) outperformed day 1 levels (AUC 0.807 vs. 0.686) in mortality prediction, with 68.5% sensitivity and 87.8% specificity. Ferritin > 1000 ng/mL emerged as an independent mortality risk factor (OR = 1.91, P = 0.004), correlating with elevated inflammatory hyperferritinemia markers (IL-6, CRP), hepatic/renal dysfunction (AST↑, eGFR↓), and coagulopathy (INR↑). Survivors exhibited a steeper ferritin decline (- 233 vs. -146 ng/mL, P < 0.001), while non-survivors sustained hyperferritinemia. The prognostic nomogram demonstrated strong discriminative ability for in-hospital mortality (AUC = 0.813) and good calibration. Decision curve analysis confirmed significant clinical net benefit across a wide probability threshold range (0.1-0.8).

conclusionEarly hyperferritinemia predicts adverse outcomes in polytrauma, reflecting systemic inflammation and organ failure. Serial ferritin monitoring post-injury enhances risk stratification, offering a pragmatic biomarker for guiding intensive care and targeted interventions.

Indexed as

FerritinsHyperferritinemiaInflammationMultiple TraumaAdultAgedBiomarkersCohort StudiesFemaleHumansMaleMiddle AgedPrognosisProspective StudiesBiomarkersFerritinsFerritinHyperferritinemiaPolytraumaProspective study

Identifiers

PMID40906216

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.