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KMID : 0604020080230010013
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Korean Journal of Critical Care Medicine
2008 Volume.23 No. 1 p.13 ~ p.17
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Causes of Fever in the ICU - A Prospective, Cohort Study
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Jeon Eun-Ju
Jung Jae-Woo
Song Ju-Han
Choi Jae-Cheol
Shin Jong-Wook
Kim Jae-Yeol
Park In-Won
Choi Byoung-Whui
Kwak Hee-Won
Kang Hyung-Gu
Lee Hye-Min
Cho Sung-Keun
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Abstract
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Background: Fever develops in 70% of ICU patients. In the present study, we tried to figure out causes of fever and the prognosis of febrile patients in the ICU in a prospective, cohort method.
Methods: From February to June 2007, patients admitted to medical ICU were daily screened and those who developed fever were enrolled. 237 consecutive admissions of 237 patients over a 5-month period were analyzed. Clinical parameters, including demographic data, underlying diseases, duration of ICU stay, causes of fever and final
outcome were analyzed.
Results: Fever (core temperature ≥38.3oC) was present in 8% of admission, and it was caused by infective (84.2%) and non-infective processes (15.8%). Most fever occurred within first 5 days in the course of the admission (68.4%) and most lasted less than 5 days (57.9%). The median Acute Physiology and Chronic Health Evaluation (APACHE) III score at the time of fever was 43 (±19). Those with infectious fever had no significant differences in terms of severity of diseases in comparison with those with non-infectious cause of fever. The most common cause of infective fever was pneumonia (n=11). Prolonged fever (≥5 days), all of which was caused by infection, occurred in 11 patients. Those with prolonged fever had higher mortality rate than short duration of fever (37.5% vs 0%, p＜0.05).
Conclusions: Infection, especially pneumonia is common cause of fever in the ICU. Prolonged fever is associated with high mortality rate
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KEYWORD
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Fever, Infection, Intensive care
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