AI Article Synopsis
- Patients with normothermia in the emergency department had lower rates of antibiotic initiation compared to those with hyperthermia, which is a concerning trend in treating infections.
- The study examined over 5,900 patients and found that those with hyperthermia received antibiotics more frequently (53.5%) than normothermic patients (27.6%).
- Additionally, normothermic patients had higher 30-day mortality rates (7.4%) compared to those with hyperthermia (4.7%), indicating a potential risk factor for worse outcomes in septic patients.
Article Abstract
Background And Importance: Previous studies found that septic patients with normothermia have higher mortality than patients with fever. We hypothesize that antibiotic therapy is less frequently initiated if infectious patients present with normothermia to the emergency department (ED).
Objectives: To examine the association of body temperature with the initiation of antibiotic therapy in patients attending the ED with suspected and proven infection. Additionally, the association of temperature with 30-day mortality was assessed.
Design, Settings And Participants: We conducted a retrospective cohort study between 2012 and 2016 at a tertiary university hospital. Adult patients attending the ED with a blood culture taken (i.e. suspected infection) and a positive blood culture (i.e. proven bacteremia) were included.
Exposure: Tympanic temperature at arrival was categorized as hypothermia (<36.1°C), normothermia (36.1-38.0°C) or hyperthermia (>38.0°C).
Outcome Measures And Analysis: Primary outcome was the initiation of antibiotic therapy. A secondary outcome was 30-day mortality. Multivariable logistic regression was used to control for covariates.
Main Results: Of 5997 patients with a suspected infection, 45.8% had normothermia, 44.6% hyperthermia and 5.6% hypothermia. Patients with hyperthermia received more often antibiotic therapy (53.5%) compared to normothermic patients (27.6%, adjusted odds ratio [95% confidence interval], 2.59 [2.27-2.95]). Patients with hyperthermia had lower mortality (4.7%) than those with normothermia (7.4%, adjusted odds ratio [95% confidence interval], 0.50 [0.39-0.64]). Sensitivity analyses in patients with proven bacteremia (n = 934) showed similar results.
Conclusion: Normothermia in patients presenting with infection was associated with receiving less antibiotic therapy in the ED compared to presentations with hyperthermia. Moreover, normothermia was associated with a higher mortality risk than hyperthermia.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549457 | PMC |
| http://dx.doi.org/10.1097/MEJ.0000000000000817 | DOI Listing |
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