title: Clinical factors and incidence of prolonged fever in neurosurgical patients.
abstract: OBJECTIVE
  To describe the incidence of prolonged fever in patients admitted to the neurosurgery department, and the corresponding risk indicators.
  
  
  BACKGROUND
  Prolonged fever was defined as a temperature higher than 38·3°C lasting more than five days. Prolonged fever is a common phenomenon and could lead to worsened outcomes in specific patient groups, especially for those with brain injury. However, the studies on prolonged fever in neurosurgical patients are limited and insufficient.
  
  
  METHODS
  A retrospective observational study.
  
  
  METHODS
  Retrospective data were collected from 1 January 2014 to 31 December 2014, at the neurosurgical department of a large teaching hospital. We performed univariate and multivariate analyses to identify independent indicators for prolonged fever vs. short-term fever.
  
  
  RESULTS
  Among 2845 patients, prolonged fever occurred in 466 (16%). The older patients were associated with longer duration of mechanical ventilation and hospital stay. It predominantly occurred in patients with subarachnoid haemorrhage (SAH) and traumatic brain injury. Patients receiving antibiotic treatment tended to manifest prolonged fever more frequently. Multivariate analysis revealed that the use of antibiotics, central venous catheter and prolonged mechanical ventilation were independent risk predictors for prolonged fever. Patients diagnosed with brain tumour seemed to be not associated with prolonged fever.
  
  
  CONCLUSIONS
  Prolonged fever is the common complication in neurosurgical patients. The risks of prolonged fever in patients are attributed to antibiotic therapy, use of central venous catheter and prolonged mechanical ventilation. Indicators of prolonged fever are helpful for better identification of high-risk patients and fever control.
  
  
  CONCLUSIONS
  A better reveal on the epidemiology and predictable factors of prolonged fever in neurosurgical patients will provide a better understanding on those patients who are most at risk, and therefore contribute to fever control and better outcome.
authors.affiliation: School of Nursing, Medical College of Huzhou University, Huzhou, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Wang
authors.affiliation: School of Nursing, Medical College of Soochow University, Suzhou, China.|Department of Neurosurgery, the First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Meifen
authors.initials: M
authors.lastname: Shen
authors.affiliation: Department of Infection Control, the First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Meizhen
authors.initials: M
authors.lastname: Qiao
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Haiyin
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.
authors.forename: Zaixiang
authors.initials: Z
authors.lastname: Tang
mesh_terms: D000367:Age Factors; D000368:Aged; D001927:Brain Diseases / Q000150:complications*; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: antibiotic therapy; central venous catheter; neurosurgical patients; prolonged fever; prolonged mechanical ventilation