Fever on hospital admission is associated with increased disease severity and mortality in acute pancreatitis: a systematic review and meta-analysis.

IF 5.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews Pub Date : 2026-07-21 DOI:10.1186/s13643-026-03265-z

Eszter Pakai, Krisztian Klonfar, Anna Walter, Nelli Farkas, Anna Sara Bognar, Jimin Lee, Peter Hegyi, Andras Garami

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引用次数: 0

Abstract

Background: Acute pancreatitis (AP) is often accompanied by changes in body temperature (T_b), but whether and how T_b at hospital admission is associated with the outcome of the disease remained unclear. Previous studies showed contradictory results regarding its prognostic value, and no meta-analysis was performed.

Methods: In this systematic review and meta-analysis, we searched the PubMed, Embase, and CENTRAL databases (from inception to April 25, 2024) for studies in adult AP patients with reported admission T_b and mortality rate or a disease severity marker. With a random-effects model, we calculated pooled proportion (for mortality) or pooled mean (for secondary outcomes) with 95% CI and compared them between febrile and afebrile subgroups. With meta-regression, we assessed the correlation between admission T_b and mortality or length of hospital stay (LOS).

Results: We found 26 eligible studies including data from 40,630 AP patients. The pooled mortality rate was higher (p < 0.001) in febrile patients (0.15, 95% CI 0.11-0.20; I² = 40%) than in afebrile patients (0.05, 95% CI 0.03-0.09; I² = 98%). LOS was longer (p = 0.025) in the febrile subgroup (39.1 days, 95% CI 16.8-61.4; I² = 91%) than in the afebrile subgroup (17.5 days, 95% CI 7.6-27.5; I² = 96%). With meta-regression, admission T_b significantly and positively correlated with mortality (0.09, 95% CI 0.07-0.12) and LOS (16.5, 95% CI 5.6-27.5). The APACHE II score was significantly (p = 0.030) higher, while the SOFA score tended to be higher (p = 0.168) in the febrile than in the afebrile subgroup. Blood levels of amylase and C-reactive protein did not differ meaningfully between the groups.

Conclusions: Fever on admission is associated with higher mortality, increased disease severity, and longer hospitalization in AP. High-quality studies with standardized T_b measurements are needed to determine the prognostic performance of admission T_b in AP.

Systematic review registration: This study was registered with PROSPERO on 16 January 2020 (registration number: CRD42020139154).

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入院时发热与急性胰腺炎疾病严重程度和死亡率增加有关：一项系统回顾和荟萃分析

背景：急性胰腺炎（AP）通常伴有体温变化（Tb），但入院时的Tb是否以及如何与疾病结局相关尚不清楚。先前的研究显示了关于其预后价值的矛盾结果，并且没有进行meta分析。方法：在这项系统评价和荟萃分析中，我们检索了PubMed、Embase和CENTRAL数据库（从建立到2024年4月25日），以获取报告住院结核病和死亡率或疾病严重程度标志物的成年AP患者的研究。通过随机效应模型，我们计算了95% CI的合并比例（死亡率）或合并平均值（次要结局），并在发热亚组和不发热亚组之间进行了比较。通过meta回归，我们评估了入院结核病与死亡率或住院时间（LOS）之间的相关性。结果：我们找到了26项符合条件的研究，包括40,630例AP患者的数据。合并死亡率高于发热患者（p 2 = 40%）（0.05, 95% CI 0.03-0.09; I2 = 98%）。发热亚组的LOS（39.1天，95% CI 16.8 ~ 61.4; I2 = 91%）较发热亚组（17.5天，95% CI 7.6 ~ 27.5; I2 = 96%）更长（p = 0.025）。通过meta回归，入院结核病与死亡率（0.09,95% CI 0.07-0.12）和LOS （16.5, 95% CI 5.6-27.5）显著正相关。发热亚组APACHEⅱ评分显著高于无发热亚组（p = 0.030）， SOFA评分高于无发热亚组（p = 0.168）。血液中淀粉酶和c反应蛋白的水平在两组之间没有显著差异。结论：入院时发热与AP患者较高的死亡率、疾病严重程度增加和住院时间延长相关。需要采用标准化结核病测量的高质量研究来确定AP患者入院时结核病的预后表现。系统评价注册：该研究于2020年1月16日在PROSPERO注册（注册号：CRD42020139154）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Systematic Reviews Medicine-Medicine (miscellaneous)

CiteScore

8.30

自引率

0.00%

发文量

241

审稿时长

11 weeks

期刊介绍： Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.