title: Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review.
abstract: METHODS
  Systematic review.
  
  
  OBJECTIVE
  To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI).
  
  
  METHODS
  A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained.
  
  
  RESULTS
  The incidence of fever of all origins (both known and unknown) after SCI ranged from 22.5 to 71.7% with a mean incidence of 50.6% and a median incidence of 50.0%. The incidence of fever of unknown origin (neurogenic fever) ranged from 2.6 to 27.8% with a mean incidence of 8.0% and a median incidence of 4.7%. Cervical and thoracic spinal injuries were more commonly associated with fever than lumbar injuries. In addition, complete injuries had a higher incidence of fever than incomplete injuries. The pathogenesis of neurogenic fever after acute SCI is not thoroughly understood.
  
  
  CONCLUSIONS
  Neurogenic fevers are relatively common following an acute SCI; however, there is little in the scientific literature to help physicians prevent or treat this condition. The paucity of research underscored by this review demonstrates the need for further studies with larger sample sizes, focusing on incidence rate, clinical outcomes, and pathogenesis of neurogenic fever following acute traumatic SCI.
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Savage
authors.affiliation: Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Christina V
authors.initials: CV
authors.lastname: Oleson
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Gursukhman S
authors.initials: GS
authors.lastname: Sidhu
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
keywords: acute spinal cord injury; autonomic dysreflexia; fever; neurogenic fever; neurologic intensive care; spinal cord injuries; spine trauma; thermoregulation