중환자실 발열의 원인-전향적, 코호트 연구Causes of Fever in the ICU-A Prospective, Cohort Study
- Authors
- 전은주; 이혜민; 조성근; 강형구; 곽희원; 신종욱; 송주한; 정재우; 최재철; 박인원; 최병휘; 김재열
- Issue Date
- 2008
- Publisher
- 대한중환자의학회
- Keywords
- Fever; Infection; Intensive care
- Citation
- Acute and Critical Care, v.23, no.1, pp 13 - 17
- Pages
- 5
- Journal Title
- Acute and Critical Care
- Volume
- 23
- Number
- 1
- Start Page
- 13
- End Page
- 17
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/31353
- ISSN
- 2586-6052
2586-6060
- Abstract
- 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 ≥38.3℃) 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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