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Table 1 Summary of key observational studies of fever and fever management in ICU patients

From: Fever management in intensive care patients with infections

 

Design, setting, and participants

Key findings

Laupland et al. 2008 [30]

Retrospective cohort study of patients admitted to four ICUs in Calgary between 2000 and 2006; n = 24,204 ICU admissions in 20,466 patients

•Fever of ≥ 38.3 °C developed during 44 % of ICU admissions and high fever ≥ 39.3 °C during 8 % of admissions

• Fever was not associated with increased ICU mortality but high fever was associated with a significantly increased risk of death

Young et al. 2011 [31]

Inception cohort study in three tertiary ICUs in Australia and New Zealand over six weeks in 2010 identifying patients with fever > 38 °C and known or suspected infection; n = 565

9 % of patients admitted to ICU had or developed a fever and known or suspected infection

Selladurai et al. 2011 [32]

Retrospective cohort study of patients admitted to a single tertiary ICU in Australia with sepsis between December 2009 and August 2010; n = 106

• 69 % of septic patients received paracetamol at least once during their first seven days in ICU

• 88 % of septic patients with a fever > 38 °C received paracetamol during their first seven days in ICU

• Septic patients with a fever > 38 °C were 6.8 times (95 % CI 1.9-24.7) more likely to receive paracetamol than septic patients who were not febrile

Lee et al. 2012 [33]

Inception cohort study of consecutive patients admitted to 25 ICUs in Japan and Korea for more than 48 hours over three months in 2009; n = 1,425

• NSAID use independently associated with increased 28-day mortality in patients with sepsis (adjusted OR 2.61; 95 % CI 1.11-6.11; p = 0.03) but with a trend towards a decreased 28-day mortality in patients without sepsis (adjusted OR 0.22; 95 % 0.031.74; p = 0.15)

• Paracetamol use independently associated with increased 28-day mortality in patients with sepsis (adjusted OR 2.05; 95 % CI 1.19-3.55; p = 0.01) but with a trend towards a decreased 28-day mortality in patients without sepsis (adjusted OR 0.58; 95 % 0.06-5.26; p = 0.63)

Laupland et al. 2012 [34]

Inception cohort study of patients admitted to French ICUs contributing to the Outcomerea database between April 2000 and November 2010; n = 10,962

• 25.7 % of patients had a fever of ≥ 38.3 °C at ICU presentation

•Fever was not associated with increased mortality but hypothermia was an independent predictor of death in medical patients

Young et al. 2012 [35]

Retrospective cohort study of 636,051 patients in Australia, New Zealand and the UK admitted to the ICU between 2005 until 2009

• Elevated body temperature in the first 24 hours in ICU was associated with an increased risk of mortality in patients without infections and a decreased risk of mortality in patients with infections

Niven et al. 2012 [36]

Interrupted time series analysis of cumulative fever incidence in ICUs in Calgary from 2004-2009

• The cumulative incidence of fever ≥ 38.3 during ICU admission decreased from 50.1 % to 25.5 % over the 5.5 years of the study

  1. CI: confidence interval; ICU: intensive care unit; NSAIDs: non-steroidal anti-inflammatory drugs; OR: odds ratio