None listed
Conditions
Brief summary
Fever is common in critically ill patients. Maintaining a normal temperature (“normothermia”) in the acute phase after brain injury is considered to be the default clinical practice. This is based on theoretical rationale, data from animal studies, and, observational clinical studies. In the context of neurological injury, the febrile response may be a marker of illness severity, may potentially represent a modifiable risk factor for morbidity and mortality, or, may be linked to a protective host response to illness. We intend to test the hypothesis that early fever would have an independent association with worse outcome in the presence of neurological injury except for neurological infection. Specifically, we hypothesize that peak temperature during the first 24 hours after ICU admission would be associated with increased mortality in patients admitted with an admission diagnostic codes for stroke and TBI, but, reduced mortality, in those with neurological infections.
Interventions
This is a retrospective cohort study: The exposure is peak temperature in the first 24 hours of intensive care admission and this will be treated as a categorical variable, divided into 0.5 degrees celsius increments. We will report odds ratios for risk of death relative to normal temperature defined as the range from 36.0 degrees to 37.5 degrees celcius.
The outcome reported in the retrospective database is mortality at hospital discharge.
The study will include all patients admitted to an
This is a retrospective cohort study: The exposure is peak temperature in the first 24 hours of intensive care admission and this will be treated as a categorical variable, divided into 0.5 degrees celsius increments. We will report odds ratios for risk of death relative to normal temperature defined as the range from 36.0 degrees to 37.5 degrees celcius. The outcome reported in the retrospective database is mortality at hospital discharge. The study will include all patients admitted to an adult ICU at one of 129 centres in Australia and New Zealand (ANZ) or one of 201 centres in the United Kingdom (UK) between 2005 and 2010.
Sponsors
Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
We will include patients with a diagnosis of traumatic brain injury, ischaemic stroke, subarachnoid haemorrhage, intracranial haemorrhage and central nervous system infections according to the coding systems of the ANZICS APD (APACHE III Diagnostic Categories) and the ICNARC Coding Method (ICM). ANZICS APD Codes: 1601, 601, 409, 1502, 403, 402, 1503, 1501, 401, 404 ICNARC Codes:1.4.2.38.1 to 1.4.2.38.8, 2.4.2.38.1 to 2.4.2.38.8, 1.4.2.15.2, 1.4.2.41.1, 1.4.2.41.2, 2.4.2.15.2, 2.4.2.41.1, 2.4.2.41.2, 2.4.2.41.3, 1.4.2.15.1, 1.4.2.15.3 to 1.4.2.15.4, 2.4.2.15.1, 2.4.2.15.3 to 2.4.2.15.41.4.2.27.1 to 1.4.2.27.3, 1.4.2.27.5 to 1.4.2.27.8, 2.4.2.27.1 to 2.4.2.27.3, 2.4.2.27.5 to 2.4.2.27.8
Exclusion criteria
Patients admitted following a cardiac arrest due to the confounding effect of therapeutic hypothermia; patients with missing data for either temperature, or admission diagnosis or vital status at hospital discharge; and patients with insufficient information on GCS. Where patients are admitted to ICU more than once during a hospital admission, only the patient’s first admission will be included in the analysis.
Outcome results
None listed