@article{16373,
  author = { and Young P. and Beasley R. and Pilcher D. and Finfer Simon and Harrison D. and Rowan K. and Bellomo Rinaldo and Bailey M. and M. Saxena},
  title = {Early peak temperature and mortality in critically ill patients with or without infection},
  abstract = {<p>
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 degrees C, the lowest risk was at 39-39.4 degrees C (adjusted OR 0.56; 95% CI 0.48-0.66). In patients without infection, the adjusted mortality risk progressively increased above 39.0 degrees C (adjusted OR 2.07 at 40.0 degrees 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.
</p>
},
  year = {2012},
  journal = {Intensive Care Medicine},
  edition = {2012/02/01},
  isbn = {1432-1238 (Electronic)0342-4642 (Linking)},
  note = {Intensive care medicineIntensive Care Med. 2012 Jan 31.},
  language = {Eng},
}