Occurrence of fever associated with thermoregulatory dysfunction after acute traumatic spinal cord injury

The medical records of 156 patients with acute traumatic Spinal Cord Injury (SCI), admitted for inpatient SCI rehabilitation during the period from January 1, 1990 through December 31, 1992, were retrospectively reviewed. Seventy-one patients with acute traumatic SCI were identified at risk for thermoregulatory dysfunction (50 patients with cervical SCI and 21 with upper thoracic level SCI). A total of 713 days were documented in which febrile events occurred in 60 of 71 patients during the study period. Over 39% of these fevers measured 101 degrees F (38.3 degrees C) or greater. There were 71 days of documented febrile episodes occurring in 17 patients for which an etiology could not be determined. Fifteen of these individuals had fewer than five such febrile days each during their entire rehabilitation hospitalization. Study results indicate that in a population of patients with acute traumatic SCI at risk for thermoregulatory dysfunction, the occurrence of fever is quite high. Fever not attributable to infectious or inflammatory etiologies is uncommon. Fever attributable to thermoregulatory dysfunction in this setting should be considered only after other etiologies have been carefully excluded.