SynthesisBMC medicine2024
Utility of shaking chills as a diagnostic sign for bacteremia in adults: a systematic review and meta-analysis.
Synthesis in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical Features and 1-Year Prognosis of Patients with Suspected Sepsis and Positive Blood Cultures in the Emergency Department: A Single-Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- An 81-year-old man with rigors.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Added Value of Shaking Chills for Predicting Bacteremia in Patients with Suspected Infection.Journal of general internal medicine · 2025Observational
- Observational
- Citrobacter youngae nosocomial bacteremia from postoperative pyogenic spondylodiscitis after a minimally invasive spinal surgery.BMC infectious diseases · 2024Article
- Bladder Injury and Urinary Tract Infection Following Low-Energy Pelvic Fracture in an Elderly Patient.Cureus · 2024Article
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Authors and funding
7 authors.
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Abstract
backgroundAccurate prediction of bacteremia is essential for guiding blood culture collection and optimal antibiotic treatment. Shaking chills, defined as a subjective chill sensation with objective body shivering, have been suggested as a potential predictor of bacteremia; however, conflicting findings exist. To address the evidence gap, we conducted a systematic review and meta-analysis of studies to assess the diagnostic accuracy of shaking chills for predicting bacteremia among adult patients.
methodsWe included studies reporting the diagnostic accuracy of shaking chills or chills for bacteremia. Adult patients with suspected bacteremia who underwent at least one set of blood cultures were included. Our main analysis focused on studies that assessed shaking chills. We searched these studies through CENTRAL, MEDLINE, Embase, the World Health Organization ICTRP Search Portal, and ClinicalTrials.gov. Study selection, data extraction, evaluation for risk of bias, and applicability using the QUADAS-2 tool were conducted by two independent investigators. We estimated a summary receiver operating characteristic curve and a summary point of sensitivity and specificity of the index tests, using a hierarchical model and the bivariate model, respectively.
resultsWe identified 19 studies with a total of 14,641 patients in which the accuracy of shaking chills was evaluated. The pooled sensitivity and specificity of shaking chills were 0.37 (95% confidence interval [CI], 0.29 to 0.45) and 0.87 (95% CI, 0.83 to 0.90), respectively. Most studies had a low risk of bias in the index test domain and a high risk of bias and a high applicability concern in the patient-selection domain.
conclusionsShaking chills are a highly specific but less sensitive predictor of bacteremia. Blood cultures and early initiation of antibiotics should be considered for patients with an episode of shaking chills; however, the absence of shaking chills must not lead to exclusion of bacteremia and early antibiotic treatment.
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