Issue: 2011 > March > original article

One-year epidemiology of fever at the Emergency Department

M. Limper, D. Eeftinck Schattenkerk, M.D. de Kruif, M. van Wissen, D.P.M. Brandjes, A.J. Duits, E.C.M. van Gorp


Background: Although fever is recognised as a major
presentation symptom at Emergency Departments (EDs)
and is often used as a rationale for the institution of
antibiotics, few studies describing patients with fever as the sole inclusion criterion at the ED of a general hospital have been performed. The objective of this study is to describe epidemiology of non-surgical febrile patients at the ED and to identify risk factors for adverse outcome. Methods: Blood, sputum, urine and faeces cultures, urine sediments and throat swaps for viral diagnostics were obtained from febrile ED patients. Outcome parameters were bacterial/viral infection, non-bacterial/non-viral infection, non-infectious febrile disease; mortality, hospital admission, admission to the intensive care unit (ICU) and length of hospital stay.
Results: 213 Patients were included (87.8% were
hospitalised, 8.5% were admitted to ICU, 4.2% died). In
75 patients (35.2%), bacterial infection was confirmed; in
78 patients (36.6%) bacterial infection was suspected. In
nine patients (4.2%), viral diagnosis was confirmed; in six patients (2.8%), a viral condition was suspected. The most frequently encountered infection was bacterial pneumonia (58 patients, 27.2%). Only older age was correlated with mortality (ρ=0.176, p=0.01). Conclusion: A majority of the febrile patients were admitted to the hospital, mostly for bacterial infection. An overall mortality rate of 4.2% was registered. Only a few risk factors for adverse outcome could be identified in this cohort. Overall, the outcome of patients presenting with fever at the ED is rather benign.