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Related Experiment Videos

Chills in 'early sepsis': good for you?

J T Van Dissel1, S C Numan, J W Van't Wout

  • 1Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands. j.t.van_dissel@lumc.nl

Journal of Internal Medicine
|April 20, 2005
PubMed
Summary
This summary is machine-generated.

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Chills in early sepsis patients may indicate a better long-term survival rate, despite not predicting in-hospital death. This suggests chills might signal a more effective host response to infection.

Area of Science:

  • Infectious Diseases
  • Clinical Medicine
  • Epidemiology

Background:

  • Early sepsis, often presenting with fever from community-acquired pneumonia or pyelonephritis, poses significant mortality risks.
  • Predictive markers for sepsis outcomes, including in-hospital mortality and long-term survival, are crucial for patient management.
  • The roles of clinical signs like chills, and biological markers such as bacteraemia and endotoxaemia, require further elucidation in early sepsis.

Purpose of the Study:

  • To assess the predictive value of chills, bacteraemia, and endotoxaemia for in-hospital mortality.
  • To evaluate the association of these factors with long-term survival (5-10 years) in early sepsis patients.
  • To explore whether chills indicate a distinct patient subpopulation with potentially different host responses.

Main Methods:

Related Experiment Videos

  • Prospective cohort study of early sepsis patients presenting with fever.
  • Evaluation of in-hospital mortality and long-term survival up to 10 years.
  • Statistical analysis using Cox proportional hazards model, adjusting for age, underlying disease, tumor necrosis factor-alpha (TNF-alpha), and leucocyte count.

Main Results:

  • Febrile patients with chills were more likely to have bacteraemia (RR 3.1).
  • Chills and bacteraemia did not significantly predict in-hospital mortality.
  • Endotoxaemia was associated with higher in-hospital mortality.
  • Patients with chills showed significantly higher long-term survival rates (estimated risk of dying 0.644).

Conclusions:

  • Chills may not predict short-term mortality but are linked to improved long-term survival in early sepsis.
  • The presence of chills might identify patients with a more robust or rapid host immune response.
  • Further research into the host response mechanisms associated with chills in sepsis is warranted.