title: Brain injury and fever: hospital length of stay and cost outcomes.
abstract: Fever has been shown to be related to extended hospital stays in neurologically injured patients. We performed meta-analyses of the impact of fever on length of stay (LOS) in the Intensive Care Unit (ICU) and for total hospital length of stay, including all recent scholarship published since 1/1/1995 pertaining to thermoregulation of neurogenic fever and length of hospital stay. We also developed estimates of the financial impact on hospital costs. Fever was shown to have a large, statistically significant impact on both ICU and hospital LOS. For ICU LOS, combined effect size g = .88, Z = 4.24, P < .0001. For hospital LOS, g = .79, Z = 2.2, P = .0278. Mean additional ICU days = 5.7 days; mean additional hospital days = 8.5 days. We estimate that fever added an average of $17,414 in hospital cost to total hospital stays; mean $13,672 (95% Confidence Interval [CI]: $10,074, $17,270) in additional ICU costs and mean $3,742 (CI: -$1,203, $8,820) in additional routine costs.
authors.affiliation: Strategic Health Resources, La Canada, California, USA. nancy.reaven@strathealth.com
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Reaven
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Lovett
authors.forename: Susan E
authors.initials: SE
authors.lastname: Funk
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001930:Brain Injuries / Q000191:economics*; D016001:Confidence Intervals; D005334:Fever / Q000188:drug therapy / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000191:economics; D013997:Time Factors
chemical_list: D018712:Analgesics, Non-Narcotic