Asociación de la fiebre y el tratamiento antipirético con la progresión de la disfunción orgánica en sepsis: Cohorte prospectiva

Introduction: Whether fever and antipyretic treatment are related to progression of organ dysfunction (POD) in sepsis is not known. Objective: To evaluate the association of fever and antipyretic treatment with POD in sepsis. Methods: Prospective cohort study of patients with sepsis. Maximum axillary temperature (T° Max), antipyretic drugs total dose and daily SOFA score were recorded. POD was defined as an increase ≥ 1 point on the SOFA score. A multivariate logistic regression model was used to evaluate the studied association. Results: 305 patients were included: 163 were women (53.4 %), with a SOFA score of 8 points (6-11); 130 participants (42.62 %) had T° Max ≥ 38 °C, and 76 (24.9 %), POD. Mortality in patients with fever was 26.2 % vs. 20 % (p = 0.21), and with POD, 73.7 % vs. 5.7 % (p = 0.01). T° Max ≥ 39 °C had an OR of 4.96 (95 % CI = 1.97-12.47, p = 0.01); and the use of antipyretics, an OR of 1.04 (95 % CI: 0.58-1.86, p = 0.88). Conclusions: An axillary T° Max ≥ 39 °C is a risk factor for POD in sepsis. The use of antipyretics was not associated with POD.