Clinical significance of daily fever frequency on traumatic brain injury

doi:10.3877/cma.j.issn.2095-9141.2021.03.003

Abstract

Abstract:

Objective

To explore the relationship between daily fever frequency and early injury changes in patients with traumatic brain injury (TBI).

Methods

Four hundred and sixty-nine patients with TBI treated in Neurosurgery Intensive Care Unit of the First Affiliated Hospital, Air Force Military Medical University from October 2013 to June 2019 were analyzed retrospectively. According to the GOS scores at the time of discharge, the patients were divided into two groups: the good prognosis group (GOS>3) and the poor prognosis group (GOS≤3). The daily fever frequency, ages, admission GCS and injury causes during hospitalization were collected. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors causing aggravating injury, and the diagnostic efficacy of aggravating risk factors was evaluated by the receiver operating characteristic curve (ROC). The causes of fever were further analyzed.

Results

Three hundred and nineteen patients had a poor early prognosis and 150 had a good early prognosis. Univariate analysis showed that age, admission GCS score, causes of injury and daily fever frequency may be the influencing factors of the aggravating injury with TBI (P<0.01). Multivariate Logistic regression analysis showed that age, admission GCS score and the daily fever frequency were independent risk factors to change the early injury of TBI patients. ROC curve showed that daily fever frequency had diagnostic efficacy. Further analysis showed that pulmonary infection could increase daily fever frequency, which was one of the most important factors aggravating injury.

Conclusion

It is concluded that the daily fever frequency is one risk factor aggravating injury and it can be used as a non-invasive and simple monitoring method to judge the injury changes.

Key words: Traumatic brain injury, Fever, Secondary brain injury, Influence factor

Xiuquan Wu, Lei Zhang, Shuang Wu, Yu Huan, Xin He, Yang Yu, Wei Du, Qingdong Guo, Zhou Fei, Xiaofan Jiang. Clinical significance of daily fever frequency on traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(03): 137-140.

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References 18

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临床因素		预后不良组(n=319)	预后良好组(n=150)	χ²/t/U值	P值
年龄（±s，岁）		48.6±17.0	40.7±15.0	4.875	<0.001
性别（男/女）		271/48	127/23	0.113	0.933
入院GCS评分（±s，分）		5.5±2.3	9.4±3.5	-12.239	<0.001
致伤因素[例(%)]				17.503	<0.001
	车祸伤	139(43.5)	51(34.0)
	坠落伤	79(24.7)	22(14.6)
	其他	101(31.8)	77(51.4)
入院平均动脉压（±s，mmHg）		97.6±13.6	94.7±11.5	2.389	0.018
住院时长[M(P₂₅，P₇₅)，d]		13(7,23)	11(8,16)	2.017	0.041
日均发热次数[M(P₂₅，P₇₅)，次]		0.9(0.3,2.3)	0.4(0.1,0.8)	5.749	<0.001

临床因素		预后不良组(n=319)	预后良好组(n=150)	χ²/t/U值	P值
年龄（±s，岁）		48.6±17.0	40.7±15.0	4.875	<0.001
性别（男/女）		271/48	127/23	0.113	0.933
入院GCS评分（±s，分）		5.5±2.3	9.4±3.5	-12.239	<0.001
致伤因素[例(%)]				17.503	<0.001
	车祸伤	139(43.5)	51(34.0)
	坠落伤	79(24.7)	22(14.6)
	其他	101(31.8)	77(51.4)
入院平均动脉压（±s，mmHg）		97.6±13.6	94.7±11.5	2.389	0.018
住院时长[M(P₂₅，P₇₅)，d]		13(7,23)	11(8,16)	2.017	0.041
日均发热次数[M(P₂₅，P₇₅)，次]		0.9(0.3,2.3)	0.4(0.1,0.8)	5.749	<0.001

临床因素	OR值	95%CI	P值
年龄	1.035	1.019～1.051	<0.001
入院GCS评分	0.667	0.609～0.730	<0.001
伤因	1.017	0.991～1.034	0.836
日均发热次数	1.528	1.200～1.946	0.001

临床因素	OR值	95%CI	P值
年龄	1.035	1.019～1.051	<0.001
入院GCS评分	0.667	0.609～0.730	<0.001
伤因	1.017	0.991～1.034	0.836
日均发热次数	1.528	1.200～1.946	0.001

发热可能原因	预后不良组(n=289)	预后良好组(n=122)	χ²值	P值
单纯肺部感染	154(53.2)	36(29.5)	21.728	<0.001
单纯颅内感染	3(1.0)	2(1.6)		0.320
合并肺部及颅内感染	3(1.0)	0		0.285
其他原因	129(44.8)	84(68.9)	20.136	<0.001

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