Journal article
Early antipyretic exposure does not increase mortality in patients with gram-negative severe sepsis: a retrospective cohort study
Internal and emergency medicine, Vol.7(5), pp.463-470
10/2012
DOI: 10.1007/s11739-012-0848-z
PMCID: PMC3510482
PMID: 22926744
Abstract
Existing data suggest that antipyretic medications may have deleterious effects on immune function and may increase mortality in human infection. This study was designed to evaluate the impact of antipyretic therapy on 28-day in-hospital mortality when administered early in the course of gram-negative severe sepsis or septic shock. This study was a single-center retrospective cohort study at a 1,111-bed academic medical center of all febrile patients with gram-negative bacteremia hospitalized with severe sepsis or septic shock (n = 278) between Jan 2002 and Feb 2008. Although the raw mortality was lower in the group that received an early antipyretic medication (22 vs. 35 %, p = 0.01), patients in the early antipyretic group had higher mean arterial pressure (58.0 vs. 52.7, p = 0.01) and higher 24-h T
max (39.3 vs. 39.0, p < 0.01). Early antipyretic therapy was not significantly associated with 28-day in-hospital mortality (adjusted OR 0.55, 0.29–1.03) in a multivariable logistic regression model controlling for APACHE-II score, hypotension, pneumonia, surgery during hospitalization, persistent fever, and in-hospital dialysis. In conclusion, early antipyretic therapy is not associated with increased mortality.
Details
- Title: Subtitle
- Early antipyretic exposure does not increase mortality in patients with gram-negative severe sepsis: a retrospective cohort study
- Creators
- Nicholas Mohr - Division of Critical Care, Department of Anesthesia, Department of Emergency Medicine University of Iowa Roy J. and Lucille A. Carver College of Medicine 200 Hawkins Drive, 1008 RCP Iowa City IA 52242 USALee Skrupky - Department of Pharmacy Barnes-Jewish Hospital 216 S. Kingshighway Blvd., Mailstop 90-52-411 St. Louis MO 63110 USABrian Fuller - Division of Critical Care, Department of Anesthesiology, Division of Emergency Medicine Washington University School of Medicine 660 South Euclid Avenue Box 8054 St. Louis MO 63110 USAHawnwan Moy - Division of Emergency Medicine Washington University School of Medicine 660 South Euclid Avenue Box 8072 St. Louis MO 63110 USARobert Alunday - Division of Emergency Medicine Washington University School of Medicine 660 South Euclid Avenue Box 8072 St. Louis MO 63110 USAMichael Wallendorf - Division of Biostatistics Washington University School of Medicine 660 South Euclid Avenue Box 8067 St. Louis MO 63110 USAScott Micek - Department of Pharmacy Barnes-Jewish Hospital 216 S. Kingshighway Blvd., Mailstop 90-52-411 St. Louis MO 63110 USARichard Fagley - Divisions of Critical Care and Cardiothoracic Anesthesiology, Department of Anesthesiology University of Washington School of Medicine 1959 NE Pacific Street, BB-1469 Box 356540 Seattle WA 98195-6540 USA
- Resource Type
- Journal article
- Publication Details
- Internal and emergency medicine, Vol.7(5), pp.463-470
- DOI
- 10.1007/s11739-012-0848-z
- PMID
- 22926744
- PMCID
- PMC3510482
- NLM abbreviation
- Intern Emerg Med
- ISSN
- 1828-0447
- eISSN
- 1970-9366
- Publisher
- Springer Milan; Milan
- Language
- English
- Date published
- 10/2012
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984024522302771
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