Jelena Djurica, Dunja Becejac, Sonja Adamovic, Sonja Mitic, Tijana Djukic, D. Lendak
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A retrospective study included 597 patients with sepsis who were divided into two groups: the first included patients with elevated body temperature (? 37.7 ?) and the second included patients who were afebrile (< 37.7 ?). Demographic data, clinical, laboratory and microbiological data, gas analysis parameters, length of hospitalization, and data on the disease outcome were collected and analyzed for all patients. Results. The results show that 41.9% of patients with sepsis did not have fever in the first 24 hours of hospitalization. In the group of afebrile patients, the average age was higher (67.38 ? 14.63 vs. 61.38 ? 18.96 years; p < 0.001) and comorbidities were more common. Patients with elevated body temperature had a significantly lower degree of organ dysfunction measured by the Sequential Organ Failure Assessment score compared to afebrile patients. There were 29.2% of patients with lethal outcome in the group of afebrile patients compared to 18.4% of deceased febrile patients. Conclusion. We conclude that the absence of fever does not rule out the diagnosis of sepsis, but on the contrary, it is associated with greater organ dysfunction and higher mortality, while the elderly are a particularly vulnerable group.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"49 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fever and sepsis - dangerous controversies\",\"authors\":\"Jelena Djurica, Dunja Becejac, Sonja Adamovic, Sonja Mitic, Tijana Djukic, D. Lendak\",\"doi\":\"10.2298/mpns2212344d\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction. Sepsis is the body?s response to infection, leading to tissue and organ damage. Although fever was considered to be an important sign of sepsis, it has been shown that half of the critically ill patients with sepsis do not have fever at the time of diagnosis. Absence of high body temperature may be a serious disruption of the thermoregulatory response to infection and therefore a reflection of the disease severity. The aim of this study was to determine the percentage of patients with sepsis without fever, and to compare the clinical presentation and outcome of the disease in febrile and afebrile patients. Material and Methods. A retrospective study included 597 patients with sepsis who were divided into two groups: the first included patients with elevated body temperature (? 37.7 ?) and the second included patients who were afebrile (< 37.7 ?). Demographic data, clinical, laboratory and microbiological data, gas analysis parameters, length of hospitalization, and data on the disease outcome were collected and analyzed for all patients. Results. The results show that 41.9% of patients with sepsis did not have fever in the first 24 hours of hospitalization. In the group of afebrile patients, the average age was higher (67.38 ? 14.63 vs. 61.38 ? 18.96 years; p < 0.001) and comorbidities were more common. Patients with elevated body temperature had a significantly lower degree of organ dysfunction measured by the Sequential Organ Failure Assessment score compared to afebrile patients. There were 29.2% of patients with lethal outcome in the group of afebrile patients compared to 18.4% of deceased febrile patients. Conclusion. 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引用次数: 0
摘要
介绍。败血症是身体吗?对感染的反应,导致组织和器官损伤。虽然发烧被认为是脓毒症的重要标志,但已有研究表明,一半的脓毒症危重患者在诊断时没有发烧。没有高体温可能是对感染的体温调节反应的严重破坏,因此反映了疾病的严重程度。本研究的目的是确定无发热脓毒症患者的百分比,并比较发热和不发热患者的临床表现和结果。材料和方法。一项回顾性研究包括597例败血症患者,他们被分为两组:第一组包括体温升高(?37.7℃),第二组为发热患者(< 37.7℃)。收集并分析所有患者的人口统计数据、临床、实验室和微生物学数据、气体分析参数、住院时间和疾病结局数据。结果。结果显示,41.9%的脓毒症患者在入院前24小时内没有发热。发热组患者平均年龄较高(67.38 ?14.63 vs. 61.38 ?18.96年;P < 0.001),合并症更为常见。与发热患者相比,体温升高的患者在序贯器官衰竭评估评分中器官功能障碍程度明显较低。发热患者组中有29.2%的患者死亡,而死亡的发热患者中有18.4%死亡。结论。我们的结论是,不发烧并不排除败血症的诊断,相反,它与更大的器官功能障碍和更高的死亡率有关,而老年人是一个特别脆弱的群体。
Introduction. Sepsis is the body?s response to infection, leading to tissue and organ damage. Although fever was considered to be an important sign of sepsis, it has been shown that half of the critically ill patients with sepsis do not have fever at the time of diagnosis. Absence of high body temperature may be a serious disruption of the thermoregulatory response to infection and therefore a reflection of the disease severity. The aim of this study was to determine the percentage of patients with sepsis without fever, and to compare the clinical presentation and outcome of the disease in febrile and afebrile patients. Material and Methods. A retrospective study included 597 patients with sepsis who were divided into two groups: the first included patients with elevated body temperature (? 37.7 ?) and the second included patients who were afebrile (< 37.7 ?). Demographic data, clinical, laboratory and microbiological data, gas analysis parameters, length of hospitalization, and data on the disease outcome were collected and analyzed for all patients. Results. The results show that 41.9% of patients with sepsis did not have fever in the first 24 hours of hospitalization. In the group of afebrile patients, the average age was higher (67.38 ? 14.63 vs. 61.38 ? 18.96 years; p < 0.001) and comorbidities were more common. Patients with elevated body temperature had a significantly lower degree of organ dysfunction measured by the Sequential Organ Failure Assessment score compared to afebrile patients. There were 29.2% of patients with lethal outcome in the group of afebrile patients compared to 18.4% of deceased febrile patients. Conclusion. We conclude that the absence of fever does not rule out the diagnosis of sepsis, but on the contrary, it is associated with greater organ dysfunction and higher mortality, while the elderly are a particularly vulnerable group.