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Table 1 Studies reporting the aetiology of pyrexia in immunocompetent patients admitted to adult ICUs with or without an acute neurological condition

From: Pyrexia: aetiology in the ICU

       Aetiology
Study Setting Design Total patients (n) Episodes of pyrexia (n) Pyrexia definition (°C) Infectious diagnosis (n, %)a Noninfectious diagnosis (n, %)a
No acute neurological condition
Circiumaru et al., 1999 [56] Medical–surgical ICU Prospective observational study 93 70 ≥38.4 Total (37, 53) Respiratory (15, 21) BSI (9, 13) Abdominal (5, 7) Other (8, 11) Total (33, 47) ARDS (4, 6) MI (3, 4) Vasculitides (2, 3) Pancreatitis (1, 1) Atelectasis (1, 1) GVHD (1, 1) ICH (1, 1) Unclear (20, 29)b
Peres Bota et al., 2004 [57] Medical–surgical ICU Prospective observational study 493 139 ≥38.3 Total (76, 55) Total (63, 45) Postoperative (27, 19) Cerebral hemorrhage (20, 14) Trauma (5, 4) ARDS (3, 2) MI (2, 1) Pancreatitis (3, 2) GI bleed (3, 2)
Barie et al., 2004 [2] Surgical ICU Prospective observational study 2419 626 ≥38.2 Total (286, 46)c Total (330, 53)c
Laupland et al., 2008 [3] 3 medical–surgical ICUs, 1 CVICU Retrospective observational study 20,466d 10,730 ≥38.3 Culture-positive (1847, 17) BSI (1004, 9) Culture-negative (8883, 83)
Niven et al., 2011 [36] 3 medical–surgical ICUs, 1 CVICU Retrospective observational study 7535 100e ≥38.3 Total (73, 73) Pneumonia (51, 51) BSI (6, 6) Other (15, 15) Total (27, 27)
Gozzoli et al., 2001 [58] Surgical ICU RCT 38 38 ≥38.5 Total (18, 47) Total (20, 53)
Niven et al., 2013 [59] 2 medical–surgical ICUs RCT 26 26 ≥38.3 Total (23, 88) Respiratory (15, 58) UTI (2, 8) BSI (1, 4) Other (5, 19) Total (3, 12)
Schortgen et al., 2012 [11] 7 medical–surgical ICUs RCT 200 200 >38.3 Total (200, 100)f Lungs (138, 69) Abdomen (13, 7) Genitourinary (12, 6) Other (28, 14) Unknown (9, 5) Not applicable
Young et al., 2015 [12] 23 medical–surgical ICUs RCT 700 700 >38.0 Total (700, 100)f Respiratory (237, 34) Abdominal (92, 13) UTI (68, 10) BSI (42, 6) Skin/soft tissue (54, 8) Other (207, 30) Not applicable
Acute neurological condition
Commichau et al., 2003 [49] Neurological ICU Prospective observational study 387 87 ≥38.3 Total (45, 52)g Respiratory (37, 42) Clostridium difficile (4, 4) UTI (3, 3) Sinusitis (1, 1) Total (2, 2) DVT (2, 2)
Rabinstein et al., 2007 [45] Neurological ICU Prospective observational study 93 93 ≥38.3 Total (62, 67) Respiratory (46, 49) Other (16, 17) Total (31, 33) Central fever (27, 29) Alcohol withdrawal (3, 3) Phenytoin toxicity (1, 1)
Hocker et al., 2013 [51] Neurological ICU Retrospective observational study 526 526 >38.3 Total (280, 53) Total (246, 47)
  1. aProportion refers to percentage of total number of pyrexia episodes
  2. bInconsistencies in reporting of pyrexia aetiologies; total number infectious and noninfectious aetiologies did not total the number of pyrexia episodes
  3. cDetailed data for infectious and noninfectious aetiologies presented in graphical format only
  4. dA total of 24,204 ICU admissions among 20,466 patients
  5. eConvenience sample of 100 randomly selected patients. Total number of patients with fever during study period was 2216
  6. fBoth Schortgen et al. [11] and Young et al. [12] preferentially enrolled patients with suspected or confirmed infection
  7. gForty-two pyrexia episodes did not have a clear aetiology
  8. ARDS acute respiratory distress syndrome, BSI bloodstream infection, CVICU cardiovascular intensive care unit, DVT deep vein thrombosis, GI gastrointestinal, GVHD graft versus host disease, ICH intracerebral hemorrhage, MI myocardial infarction, RCT randomized controlled trial, UTI urinary tract infection