• Daliana Peres Bota, Flavio Lopes Ferreira, Christian Mélot, and Jean Louis Vincent.
• Department of Intensive Care, Erasme University Hospital, Free University of Brussels, 808 Route de Lennik, 1070 Brussels, Belgium.
• Intensive Care Med. 2004 May 1;30(5):811-6.

ObjectiveTo determine the incidence of body temperature (BT) alterations in critically ill patients, and their relationship with infection and outcome.DesignProspective, observational study. SETTING. Thirty-one bed, medico-surgical department of intensive care.PatientsAdult patients admitted consecutively to the ICU for at least 24 h, during 6 summer months.InterventionsNone.ResultsFever (BT > or =38.3 degrees C) occurred in 139 (28.2%) patients and hypothermia (BT< or =36 degrees C) in 45 (9.1%) patients, at some time during the ICU stay. Fever was present in 52 of 100 (52.0%) infected patients without septic shock, and in 24 of 38 (63.2%) patients with septic shock. Hypothermia occurred in 5 of 100 (5.0%) infected patients without septic shock and in 5 of 38 (13.1%) patients with septic shock. Patients with hypothermia and fever had higher Sequential Organ Failure Assessment (SOFA) scores on admission (6.3+/-3.7 and 6.4+/-3.3 vs 4.6+/-3.2; p<0.01), maximum SOFA scores during ICU stay (7.6+/-5.2 and 8.2+/-4.7 vs 5.4+/-3.8; p<0.01) and mortality rates (33.3 and 35.3% vs 10.3%; p<0.01). The length of stay (LOS) was longer in febrile patients than in hypothermic and normothermic (36 degrees CConclusionsBoth hypothermia and fever are associated with increased morbidity and mortality rates. Patients with hypothermia have a worse prognosis than those with fever.

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