The present study highlights the prognostic significance of HLH criteria in critically ill patients. Individuals exhibiting two or more criteria at ICU admission experienced nearly a doubling in mortality as compared to patients with no or only one criterion met.

The exceeding mortality rate of more than 40% in such patients underscores the need for early recognition and intervention in this population.

Among the individual markers, sCD25 emerged as a significant predictor of survival, independently of traditional ICU risk factors.

Furthermore, high fibrinogen levels were associated with improved outcomes and enhanced the predictive accuracy of the SAPS II score.

Despite the established diagnostic relevance of ferritin and triglycerides in HLH, their prognostic value in predicting 30-day mortality was limited.

Further research is essential to refine risk stratification and develop targeted therapies for HLH in the ICU and could ultimately improve patient outcomes.

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