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At the same time, inflammation might be continuously present in cirrhotic patients due to bacterial translocation and patients\u2019 susceptibility to infections. Ferritin is a sensitive and widely available marker of iron homeostasis, in addition it acts as an acute phase protein. Therefore, we evaluated the prognostic potential of serum ferritin in the long-term follow-up of cirrhotic outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 244 cirrhotic outpatients was recruited and followed for 2\u00a0years. We measured their serum ferritin levels in our routine laboratory unit at enrolment and investigated its association with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ferritin serum level was higher in males and older patients than in females (median: 152.6 vs. 75\u00a0\u03bcg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or younger individuals (median: 142.9 vs. 67.9\u00a0\u03bcg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Patients who previously survived variceal bleeding had lower ferritin levels (median: 43.1 vs. 146.6\u00a0\u03bcg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariate regression models, including laboratory and clinical factors, lower (&lt;\u200940\u00a0\u03bcg\/L) ferritin concentration was associated with the development of decompensated clinical stage in patients with previously compensated cirrhosis (sHR: 3.762, CI 1.616\u20138.760,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), while higher (&gt;\u2009310\u00a0\u03bcg\/L) circulating ferritin levels were associated with increased risks of bacterial infections in decompensated patients (sHR: 2.335, CI 1.193\u20134.568,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and mortality in the whole population (HR: 2.143, CI 1.174\u20133.910,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We demonstrated usefulness of serum ferritin as a prognostic biomarker in cirrhosis, pointing out that both low and high concentrations need attention in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-021-01669-w","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T02:02:34Z","timestamp":1614650554000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Abnormal ferritin levels predict development of poor outcomes in cirrhotic outpatients: a cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"David","family":"Tornai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Antal-Szalmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Tornai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Papp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istvan","family":"Tornai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Sipeki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Janka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boglarka","family":"Balogh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsanna","family":"Vitalis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"1669_CR1","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/S0168-8278(98)80011-1","volume":"29","author":"SJ Cotler","year":"1998","unstructured":"Cotler SJ, Bronner MP, Press RD, Carlson TH, Perkins JD, Emond MJ, et al. 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Each patient or legal guardian was informed of the nature of the study and signed an informed consent form.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}