Occurrence and outcome of fever in critically ill adults

Critical Care Medicine
Kevin B LauplandHenry T Stelfox

Abstract

Although fever is common in the critically ill, only a small number of studies have specifically investigated its epidemiology in the intensive care unit (ICU). The objective of this study was to describe the occurrence of fever in the critically ill and assess its effect on ICU outcome. Retrospective cohort. Fever was defined by temperature > or = 38.3 degrees C and high fever by > or = 39.5 degrees C. Calgary Health Region during 2000-2006. All adults (> or = 18 yrs) admitted to ICUs. None. A total of 24,204 ICU admission episodes occurred among 20,466 patients; 35% were classified as medical, 33% as cardiac surgical, 16% as other surgical, and 15% as trauma/neurologic. The cumulative incidence of fever and high fever was 44% and 8% and the incidence density was 24.3 and 2.7 per 100 days of ICU admission, respectively. The incidence density of fever was higher in trauma/neuro patients, males, younger patients, and was lower in those with admission Acute Physiology and Chronic Health Evaluation II scores > or = 25. Seventeen percent and 31% of patients with fever and high fever had associated positive cultures. Resolution of fever and high fever occurred in 27% and 53% of patients before ICU discharge and prolonged fever and h...Continue Reading

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