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Fever in Trauma Patients without Brain Injury

Journal of Acute Care Surgery 2021년 11권 1호 p.6 ~ 13
최보윤, 성기영, 조진범,
소속 상세정보
최보윤 ( Choi Bo-Yoon ) - Catholic University College of Medicine Department of Surgery
성기영 ( Sung Ki-Young ) - Catholic University College of Medicine Department of Surgery
조진범 ( Cho Jin-Beom ) - Catholic University College of Medicine Department of Surgery

Abstract


Purpose: Distinguishing a fever caused by infection from the necessary febrile response in injured patients is difficult, because trauma patients often have concomitant obvious infectious origins. In traumatic brain injury, early fever might be associated with worse clinical outcomes; however, few reports on trauma patients without brain injury are available.

Methods: In this retrospective observational study, consecutive trauma patients without brain injury who were admitted to the surgical intensive care unit during a 3 year period were included. The surgical and clinical outcomes were compared according to body temperature. Locally weighted scatterplot smoothing was used to identify the relationship between body temperature and injury severity.

Results: A total of 111 patients were included. Body temperature increased as the injury severity score increased up to 47.717, above which it decreased. Mortality was high in hypothermic patients (72.7%; p < 0.001); however, few differences were observed between normothermic and hyperthermic patients (3.5% and 2.4%, respectively). The nonsurvivors had lower body temperatures on the 1st and 2nd days after admission (36 °C and 36.9 °C) compared with the survivors (37.3 °C and 37.7 °C; p < 0.001 and p = 0.006). In severely injured patients, low levels of inflammatory biomarkers and low body temperature were correlated with mortality.

Conclusions: Fever in trauma patients without brain injury is correlated with injury severity but not with prognosis. Hypothermia on the 1st and 2nd days after admission was significantly correlated with mortality. In severely injured patients, a decreased inflammatory response might play a certain role in promoting a high mortality rate.

키워드

trauma; fever; traumatic brain injury; infection

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