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Korean J Crit Care Med > Volume 23(1); 2008 > Article
Korean Journal of Critical Care Medicine 2008;23(1): 13-17. doi: https://doi.org/10.4266/kjccm.2008.23.1.13
중환자실 발열의 원인 - 전향적, 코호트 연구
전은주ㆍ이혜민ㆍ조성근ㆍ강형구ㆍ곽희원ㆍ송주한ㆍ정재우ㆍ최재철ㆍ신종욱ㆍ박인원ㆍ최병휘ㆍ김재열
중앙대학교 의과대학 내과학교실
Causes of Fever in the ICU - A Prospective, Cohort Study
Eun Ju Jeon, Hye Min Lee, Sung Gun Cho, Hyung Koo Kang, Hee Won Kwak, Ju Han Song, Jae Woo Jung, Jae Chol Choi, Jong Wook Shin, In Won Park, Byoung Whui Choi, Jae Yeol Kim
Department of Internal Medicine, Chung Ang University College of Medicine, Seoul, Korea. babelkim@gmail.com, jykimmd@cau.ac.kr
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 > or =38.3degrees C) 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 (> or =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). CONCLUSION: Infection, especially pneumonia is common cause of fever in the ICU. Prolonged fever is associated with high mortality rate.
Key Words: Fever; Infection; Intensive care
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