Relationship between fever degree and prognosis in children with bacterial bloodstream infection

Abstract:

Objective To study the relationship between the degree of fever within 48 hours of admission and the prognosis in children with bacterial bloodstream infection. Methods This study retrospectively analyzed the clinical data of all patients diagnosed with sepsis who were admitted to the pediatric intensive care unit (PICU) of Shengjing Hospital Affiliated to China Medical University between September 2008 and September 2016. The children with bacterial bloodstream infection were classified into 5 groups according to the maximum temperature within 48 hours of admission: < 36.5℃ group, ≥36.5℃ group (normal control), ≥37.5℃ group, ≥38.5℃ group, and ≥39.5℃ group. The mortality was compared between the five groups. Results A total of 213 children with bacterial bloodstream infection were enrolled, consisting of 5 cases in the < 36.5℃ group, 44 cases in the ≥36.5℃ group, 73 cases in the ≥37.5℃ group, 69 cases in the ≥38.5℃ group, and 22 cases in the ≥39.5℃ group. A total of 48 cases died among the 213 patients. A significant difference was observed in the mortality between the five groups (P < 0.01). The < 36.5℃ group and ≥39.5℃ group had significantly higher mortality than the normal control group. However, there were no significant differences in the mortality between the ≥37.5℃ and ≥38.5℃ groups and the normal control group. Conclusions In children with bacterial bloodstream infection, those with a maximum temperature below 36.5℃ or above 39.5℃ within 48 hours of admission have a significantly increased mortality.