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Increased Body Temperature01:25

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A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
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The inflammatory response is the body's defense against infection, injury, or irritation from bacteria, trauma, toxins, or heat. Inflammation helps locate and destroy pathogens and remove damaged tissue elements to heal the body. During this initial phase, fluid, blood products, and nutrients migrate to the injured area, resulting in redness, heat, swelling, ache, and loss of function. Moreover, signs of systemic inflammation include fever, increased WBC count, malaise, anorexia, nausea,...
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Emotionally traumatic events often lead to memories that are exceptionally vivid and enduring, sometimes persisting with remarkable clarity throughout an individual's life. A classic example of this phenomenon is a person who survives a car accident. Even years later, they may recall every detail of the event with startling accuracy — the screeching of the tires, the jarring impact, and the acrid smell of burning rubber. Such vividness contrasts sharply with how an individual...
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Early fever after trauma: Does it matter?

Holly E Hinson1, Susan Rowell, Cynthia Morris

  • 1From the Department of Neurology (H.E.H.), Department of Emergency Medicine (H.E.H., A.L.L.), Department Trauma, Critical Care & Acute Surgery (S.R., M.A.S.), Department of Medical Informatics and Clinical Epidemiology (C.M.), Oregon Health & Science University, Portland, Oregon.

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Summary

Early fever after traumatic brain injury (TBI) is not more common than in other trauma patients. However, fever in any trauma patient is linked to longer intensive care unit (ICU) stays and increased hospital mortality.

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Area of Science:

  • Trauma care
  • Neuroscience
  • Critical care medicine

Background:

  • Fever is strongly associated with poor outcomes in patients with traumatic brain injury (TBI).
  • The hypothesis was that early fever is a direct result of brain injury, thus more common in TBI and linked to inflammation.

Purpose of the Study:

  • To investigate the incidence of early fever in patients with TBI compared to those without brain injury.
  • To determine the association between early fever and inflammation, neurological deterioration, and patient outcomes.

Main Methods:

  • A prospective study enrolled 268 major trauma patients in an intensive care unit (ICU).
  • Patients were categorized into four groups based on Head Abbreviated Injury Scale (AIS) scores: multiple injuries, isolated head, isolated body, and minor trauma.
  • Early fever was defined as temperature >38.3°C within 48 hours. Outcomes included ICU length of stay, mortality, neurological deterioration, and plasma cytokine levels.

Main Results:

  • The incidence of early fever (11-24%) was similar across all injury groups, regardless of brain injury.
  • Fever was significantly associated with increased hospital mortality (6-18% vs. 0-3%) and longer ICU stays (3-7 days vs. 2-3 days) in all groups.
  • In the isolated head injury group, fever correlated with elevated IL-6 levels at admission and 24 hours.

Conclusions:

  • Early fever is not more prevalent in patients with TBI compared to other trauma patients.
  • Fever, irrespective of injury type, is associated with poorer outcomes, including longer ICU stays and higher mortality.
  • Elevated IL-6 levels in isolated head injury patients with fever suggest an inflammatory link.