Association of fever and antipyretic treatment with progressive organ dysfunction in sepsis: Prospective cohort

INTRODUCTION: Whether fever and antipyretic treatment are related to progression of organ dysfunction (POD) in sepsis is currently 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.