Fever is associated with reduced, hypothermia with increased mortality in septic patients: A meta-analysis of clinical trials

Zoltan Rumbus, Robert Matics, Peter Hegyi, Csaba Zsiboras, Imre Szabo, Anita Illes, Erika Petervari, Marta Balasko, Katalin Marta, Alexandra Miko, Andrea Parniczky, Judit Tenk, Ildiko Rostas, Margit Solymar, Andras Garami

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31 Citations (Scopus)

Abstract

Background Sepsis is usually accompanied by changes of body temperature (Tb ), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. Methods We searched the PubMed, EMBASE, and Cochrane Controlled Trials Registry databases (from inception to February 2016). Human studies reporting Tb and mortality of patients with sepsis were included in the analyses. Average Tb with SEM and mortality rate of septic patient groups were extracted by two authors independently. Results Forty-two studies reported Tb and mortality ratios in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis, we found a 22.2% (CI, 19.2-25.5) mortality rate in septic patients with fever (Tb > 38.0?C), which was higher, 31.2% (CI, 25.7-37.3), in normothermic patients, and it was the highest, 47.3% (CI, 38.9-55.7), in hypothermic patients (Tb < 36.0?C). Meta-regression analysis showed strong negative linear correlation between Tb and mortality rate (regression coefficient: -0.4318; P < 0.001). Mean Tb of the patients was higher in the lowest mortality quartile than in the highest: 38.1°I, 37.9-38.4) vs 37.1° (CI, 36.7-37.4).Conclusions Deep Tb shows negative correlation with the clinical outcome in sepsis. Fever predicts lower, while hypothermia higher mortality rates compared with normal Tb . Septic patients with the lowest (< 25%) chance of mortality have higher Tb than those with the highest chance (> 75%).

Original languageEnglish
Article numbere0170152
JournalPloS one
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 2017

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Rumbus, Z., Matics, R., Hegyi, P., Zsiboras, C., Szabo, I., Illes, A., Petervari, E., Balasko, M., Marta, K., Miko, A., Parniczky, A., Tenk, J., Rostas, I., Solymar, M., & Garami, A. (2017). Fever is associated with reduced, hypothermia with increased mortality in septic patients: A meta-analysis of clinical trials. PloS one, 12(1), [e0170152]. https://doi.org/10.1371/journal.pone.0170152