ArticleInfection and drug resistance2021
Nosocomial Fever in General Medical Wards: A Prospective Cohort Study of Clinical Characteristics and Outcomes.
Article in Infection and drug resistance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence of Drug Fever among Cases of Nosocomial Fever: A Systematic Review and Meta-analysis.Internal medicine (Tokyo, Japan) · 2024Pooled it
- Diagnostic utility of sepsis screening tools, procalcitonin, and C-reactive protein in nosocomial fever of unknown origin.World journal of critical care medicine · 2025Article
- Drug fever: a narrative review.Annals of clinical epidemiology · 2023Article
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3 authors.
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Abstract
purposeNosocomial fever (NF) is a common sign of healthcare-associated infection; however, infection is not always followed up. We studied the etiology, clinical characteristics, and outcomes of nosocomial fever in hospitalized patients. PATIENTS AND
methodsBetween October 2019 and December 2020, we enrolled subjects from general medical wards who developed fever ≥48 hours after hospital admission or who were admitted with fever, defervesced, and then developed a fever ≥7 days later that was unrelated to the cause for admission. Subjects with NF underwent a comprehensive clinical evaluation and laboratory investigations.
resultsEighty-six cases of NF were identified and completely followed, the mean age was 69.29 years, and 35 were male. Fifty-seven were from infectious etiologies, 28 from non-infectious etiologies, and one case was unable to be determined. Hospital-associated pneumonia (47.4%) and urinary tract infection (22.8%) were the most common infectious causes, and malignancy (17.8%) and large hematoma (14.3%) were the most common non-infectious causes. The median day of onset of NF following hospitalization was 12 (4.7-21.2) days. Acute physiology and chronic health evaluation II (APACHE II) score (14.70 vs 11.97, p = 0.02), sequential organ failure assessment (SOFA) scores (4 vs 2, p < 0.01), pertinent clinical findings (82.5% vs 42.9%, p < 0.01), blood urea nitrogen (BUN) (37.30 vs 21.10, p = 0.03) and creatinine (1.41 vs 0.97, p = 0.05) levels, and abnormal chest radiography (45.6% vs 3.6%, p < 0.01) had significant differences between infectious and non-infectious etiologies. Twenty-three subjects (26.7%) died. The presence of end-stage renal disease (ESRD) [OR 19.49 (1.77-214.18), p = 0.015], SOFA score >6 [OR 5.18 (1.04-25.90), p = 0.045], and abnormal chest radiography [OR 3.45 (1.16-10.29), p = 0.026] were significantly associated with mortality.
conclusionNosocomial infections, malignancy, and hematoma were the leading causes of NF. Severity scores, clinical findings, renal function tests, and chest radiography were distinguishing features between infectious and non-infectious etiologies. ESRD, high SOFA scores, and abnormal chest radiography were associated with mortality.
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