Fever is associated with reduced, hypothermia with increased mortality in septic patients a meta-analysis of clinical trials /

BACKGROUND: Sepsis is usually accompanied by changes of body temperature (Tb), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. METHODS...

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Main Authors: Rumbus Zoltán
Mátics Róbert
Hegyi Péter
Zsiborás Csaba
Szabó Imre
Illés Anita
Pétervári Erika
Balaskó Márta
Márta Katalin
Mikó Alexandra
Párniczky Andrea
Tenk Judit
Rostás Ildikó
Szekeres-Solymár Margit
Garami András
Format: Article
Published: Public Library of Science (PLoS) 2017
Series:PLOS ONE 12 No. 1
doi:10.1371/journal.pone.0170152

mtmt:3167989
Online Access:http://publicatio.bibl.u-szeged.hu/11771
Description
Summary:BACKGROUND: Sepsis is usually accompanied by changes of body temperature (Tb), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. METHODS: We searched the PubMed, EMBASE, and Cochrane Controlled Trials Registry databases (from inception to February 2016). Human studies reporting Tb and mortality of patients with sepsis were included in the analyses. Average Tb with SEM and mortality rate of septic patient groups were extracted by two authors independently. RESULTS: Forty-two studies reported Tb and mortality ratios in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis, we found a 22.2% (CI, 19.2-25.5) mortality rate in septic patients with fever (Tb > 38.0 degrees C), which was higher, 31.2% (CI, 25.7-37.3), in normothermic patients, and it was the highest, 47.3% (CI, 38.9-55.7), in hypothermic patients (Tb < 36.0 degrees C). Meta-regression analysis showed strong negative linear correlation between Tb and mortality rate (regression coefficient: -0.4318; P < 0.001). Mean Tb of the patients was higher in the lowest mortality quartile than in the highest: 38.1 degrees C (CI, 37.9-38.4) vs 37.1 degrees C (CI, 36.7-37.4). CONCLUSIONS: Deep Tb shows negative correlation with the clinical outcome in sepsis. Fever predicts lower, while hypothermia higher mortality rates compared with normal Tb. Septic patients with the lowest (< 25%) chance of mortality have higher Tb than those with the highest chance (> 75%).
Physical Description:Terjedelem: 15 p-Azonosító: e0170152
ISSN:1932-6203