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Early peak temperature and mortality in critically ill patients with or without infection.
- Source :
- Intensive Care Medicine; Mar2012, Vol. 38 Issue 3, p437-444, 8p, 3 Charts, 2 Graphs
- Publication Year :
- 2012
-
Abstract
- Purpose: To determine whether fever is associated with an increased or decreased risk of death in patients admitted to an intensive care unit (ICU) with infection. Methods: We evaluated the independent association between peak temperature in the first 24 h after ICU admission and in-hospital mortality according to whether there was an admission diagnosis of infection using a database of admissions to 129 ICUs in Australia and New Zealand (ANZ) ( n = 269,078). Subsequently, we sought to confirm or refute the ANZ database findings using a validation cohort of admissions to 201 ICUs in the UK ( n = 366,973). Results: A total of 29,083/269,078 (10.8%) ANZ patients and 103,191/366,973 (28.1%) of UK patients were categorised as having an infection. In the ANZ cohort, adjusted in-hospital mortality risk progressively decreased with increasing peak temperature in patients with infection. Relative to the risk at 36.5-36.9°C, the lowest risk was at 39-39.4°C (adjusted OR 0.56; 95% CI 0.48-0.66). In patients without infection, the adjusted mortality risk progressively increased above 39.0°C (adjusted OR 2.07 at 40.0°C or above; 95% CI 1.68-2.55). In the UK cohort, findings were similar with adjusted odds ratios at corresponding temperatures of 0.77 (95% CI 0.71-0.85) and 1.94 (95% CI 1.60-2.34) for infection and non-infection groups, respectively. Conclusions: Elevated peak temperature in the first 24 h in ICU is associated with decreased in-hospital mortality in critically ill patients with an infection; randomised trials are needed to determine whether controlling fever increases mortality in such patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- CRITICALLY ill patient care
INTENSIVE care patients
FEVER
MORTALITY
PATIENTS
DISEASES
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 38
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 71960390
- Full Text :
- https://doi.org/10.1007/s00134-012-2478-3