Early peak temperature and mortality in critically ill patients with or without infection
© Saxena et al. 2011
Published: 27 October 2011
To determine whether fever is associated with reduced risk of death in patients admitted to an ICU with infection compared with other patients.
A retrospective cohort study using a database of Australian and New Zealand (ANZ) ICU admissions as a development cohort and a database of UK ICU admissions as a validation cohort. The sample included 129 ICUs in ANZ and 201 ICUs in the UK. The ANZ development cohort consisted of 269,078 patients and the UK validation cohort consisted of 366,973 patients. All patients were admitted to an ICU between 2005 and 2009. A total of 29,083/269,078 (10.8%) ANZ patients and 103,191/366,973 (28.1%) UK patients were categorised as having an infection at the time of ICU admission. The main outcome measures were the association between peak temperature in the first 24 hours after ICU admission and in-hospital mortality in patients admitted with or without infection.
Peak temperature in the first 24 hours in the ICU is associated with decreased in-hospital mortality in critically ill patients with an infection; randomised trials are needed to compare the effect on mortality of controlling fever against a permissive approach to fever management in such patients.
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