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Chills in ‘early sepsis’: good for you?
Author(s) -
VAN DISSEL J. T.,
NUMAN S. C.,
VAN'T WOUT J. W.
Publication year - 2005
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2005.01498.x
Subject(s) - chills , medicine , sepsis , pneumonia , mortality rate , cohort , prospective cohort study , surgery
. We evaluated the predictive value of chills, bacteraemia and endotoxaemia for in‐hospital mortality and survival at 5–10 years long‐term follow‐up in a prospective cohort of ‘early sepsis’ patients presenting with fever resulting from community‐acquired pneumonia or pyelonephritis. Febrile patients with chills had bacteraemia more often (RR 3.1, 95% CI 1.8–5.4) than those without chills. Neither chills nor bacteraemia were significantly related to in‐hospital mortality, but patients with endotoxaemia had a higher in‐hospital mortality rate than those without endotoxaemia. Patients with chills had a significantly higher survival rate at long‐term follow‐up than those without chills on admission: the estimated risk of dying was 0.644 (95% CI 0.43–0.95, P = 0.029) for an individual with chills, compared to a person without chills, adjusting for the other factors [age cohort, underlying disease and the pro‐inflammatory response in the blood, i.e. tumour necrosis factor‐ α (TNF‐ α ) and blood leucocyte number, as scored on hospital admission] in the Cox proportional hazards model. Chills may characterize a patient subpopulation that upon pulmonary and urinary tract infection is able to raise a more rapid and/or efficient host response.