Background: Polytrauma patients often receive antibiotic therapy because of the high risk of infection and long-lasting
posttraumatic fever.
Material and Methods: Prospectively maintained database of patients hospitalized for severe polytrauma in our intensive
care unit. We investigated the overall and daily occurrence of fever (any temperature ≥38°C or 104°F) during the first 15
days of hospitalization and its association with various categorical (Pearson-χ2-tests) or continuous variables (Wilcoxonranksum-
tests).
Results: Among 155 patients with severe polytrauma (median age 38 years), fewer occurred in 80 (55%) despite the
prescription of anti-inflammatory drugs in all cases and corticosteroids in 15 cases. Among 90 patients (58%) who were
receiving antibiotic treatment (median 2 days) during the two-week window, infection was proven microbiologically and
clinically in 18 patients (12%). Fever was noted in 80 patients (55%), or 89% (16/18) among those who were infected. This
differences was significant (χ2-test; p=0.002). Using daily stratified analyses with categorical and continuous temperature
variables confirmed the statistical association of fever with infection for each day (all p values <0.01). By multivariate
analysis, fever had a significant associated with infection (odds ratio 3.3, 95% CI 1.2-9.4); while surgery, open fractures,
and abdominal trauma did not.
Conclusions: For severe polytrauma patients in the intensive care unit fewer is frequent and significantly associated with
infection both overall and stratified upon individual days, with no apparent time threshold.