The Role of Hepcidin Level in Pediatric Mortality-related Sepsis

A BSTRACT Introduction: Hepcidin is an acute-phase reactant involved in regulating systemic iron levels. In acute infections such as sepsis, hepcidin levels rise. However, few studies have explored the role of hepcidin in assessing sepsis outcomes in children, and its relationship to mortality remains unclear. Most existing research suggests that high hepcidin levels may reduce the risk of sepsis-related death in children. This study aimed to investigate whether high hepcidin levels serve as a protective factor for clinical outcomes in pediatric sepsis. Methods: This observational analytic cohort study assessed high hepcidin levels in pediatric sepsis patients in the Pediatric Intensive Care Unit from October 2021 to June 2022, using consecutive sampling. Data were analyzed with Chi-square tests and logistic regression, with statistical significance set at P < 0.05. Results: This study involved 59 pediatric sepsis with 57.6% with age >12 years old, 61% males, 54.2% well nourished, 66.1% source infection from the respiratory tract, 54.2% septic shock, 18.6% bacteremia, 66.1% without comorbid and 54.2% outcome alive. Analysis receiver operating characteristic curve analysis showed an area under the curve (AUC) of 40.0%, with a cutoff of 1312 pg/ml to differentiate high and low hepcidin levels. Bivariate analysis showed that high hepcidin levels were protective ( P = 0.02, relative risk = 0.367). Multivariate analysis confirmed high hepcidin as a protective factor ( P = 0.048, 95% confidence interval: 0.055–0.984). Conclusions: High hepcidin level as a protective factor for death outcome on pediatric sepsis.