{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:12Z","timestamp":1777934712516,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Previous work identified a sub-group of trauma patients at risk for bacteremia who presented with signs of infection, including fever. A majority were older adult falls who had early onset bacteremia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Fever in the trauma bay is associated with a greater risk of adverse outcomes and identifies patients who might benefit from early initiation of interventions for sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Trauma patients \u226518 years, drawn from a system-wide electronic medical record (EMR) (2017\u20132020), were included. Fever+ patients (temperature &gt;38\u00b0C) were compared with Fever\u2212 patients (36\u00b0C\u201338\u00b0C). Multi-variable logistic regressions assessed the association of fever status with outcomes. The interaction between fever, age, and outcomes was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 140,647 patients were included from 89 centers. Eight hundred ninety (0.6%) were Fever+ and had worse unadjusted outcomes. After adjustment, Fever+ patients had significantly greater mortality (adjusted odds ratios [aOR], 95% confidence interval: 1.05 [1.04\u20131.07]), intensive care unit use (1.08 [1.04\u20131.11]), and ventilator use (1.11 [1.09\u20131.13]). Fever+ status was associated with a significantly larger aOR of severe sepsis in older versus younger patients (\u226565 y: 1.12 [1.11\u20131.13]; &lt;65 y: 1.04 [1.03\u20131.05]). Fever+ status was also associated with a significantly larger aOR of bacteremia in older versus younger patients (\u226565 y: 1.09 [1.08\u20131.10]; &lt;65 y: 1.04 [1.03\u20131.05]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications:<\/jats:title>\n                    <jats:p>Although uncommon, fever at presentation is an ominous sign for trauma patients and portends significantly greater risks for bacteremia, sepsis, and mortality. These risks increase with age. These findings suggest older adults who present with fever warrant early aggressive intervention and may sustain injury as a consequence of debility from systemic infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2024.184","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T12:21:21Z","timestamp":1736770881000},"page":"255-262","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fever in the Trauma Bay: A Marker for Greater Risk of Adverse Outcomes"],"prefix":"10.1177","volume":"26","author":[{"given":"Samir M.","family":"Fakhry","sequence":"first","affiliation":[{"name":"Center for Trauma and Acute Care Surgery Research, Clinical Services Group, HCA Healthcare, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Shen","sequence":"additional","affiliation":[{"name":"Center for Trauma and Acute Care Surgery Research, Clinical Services Group, HCA Healthcare, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gina M.","family":"Berg","sequence":"additional","affiliation":[{"name":"Trauma Services, Wesley Medical Center, Wichita, Kansas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Dunne","sequence":"additional","affiliation":[{"name":"Department of Trauma and Surgical Critical Care, Memorial Health University Medical Center, Savannah, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parker","family":"Hu","sequence":"additional","affiliation":[{"name":"Trauma Services, Chippenham Hospital, Richmond, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrell L.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Surgery, TriStar Skyline Medical Center, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"McKenney","sequence":"additional","affiliation":[{"name":"Trauma Services, HCA Florida Kendall Hospital, Miami, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas W.","family":"Sheets","sequence":"additional","affiliation":[{"name":"Department of Surgery, Riverside Community Hospital, Riverside, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Joseph","family":"Sliter","sequence":"additional","affiliation":[{"name":"Trauma Services, Wesley Medical Center, Wichita, Kansas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew M.","family":"Carrick","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical City Plano, Plano, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-3020","authenticated-orcid":false,"given":"Jeneva M.","family":"Garland","sequence":"additional","affiliation":[{"name":"Center for Trauma and Acute Care Surgery Research, Clinical Services Group, HCA Healthcare, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Orlando","sequence":"additional","affiliation":[{"name":"Center for Trauma and Acute Care Surgery Research, Clinical Services Group, HCA Healthcare, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"American College of Surgeons. About Advanced Trauma Life Support. Chicago IL; 2024. Available from: https:\/\/www.facs.org\/quality-programs\/trauma\/education\/advanced-trauma-life-support\/about\/ [Last accessed: April15 2024]."},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2022.228"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58121860"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-020-01489-9"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001627"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.17479\/jacs.2021.1.6"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2015856"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181aa5e8d"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70112-X"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2010.06.004"},{"key":"e_1_3_7_12_2","unstructured":"R: A language and environment for statistical computing. R Foundation for Statistical Computing Program. Vienna Austria: R Core Team; 2023. Available from: https:\/\/www.R-project.org\/ [Last accessed: February5 2024]."},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2003.11.003"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61240-3"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2017.1308609"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13836"},{"key":"e_1_3_7_19_2","unstructured":"Medicare Learning Network. Department of Health and Human Services: Centers for Medicare & Medicaid Services. Hospital-Acquired Conditions and Present on Admission Indicator Reporting Provision. Baltimore MD; 2014. Available from: https:\/\/www.cms.gov\/files\/document\/wpoafactsheetpdf [Last accessed: May27 2024]."},{"key":"e_1_3_7_20_2","unstructured":"US Centers for Medicare & Medicaid Services. Hospital-Acquired Conditions (Present on Admission Indicator). Baltimore MD; 2014. Available from: https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/HospitalAcqCond\/AffectedHospitals [Last accessed: May27 2024]."},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.8512"},{"key":"e_1_3_7_22_2","unstructured":"US Centers for Medicare & Medicaid Services. Find & Compare Providers Near You. Baltimore MD; 2014. Available from: https:\/\/www.medicare.gov\/care-compare\/ [Last accessed: May27 2024]."}],"container-title":["Surgical Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/sur.2024.184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2024.184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2024.184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:31:50Z","timestamp":1777689110000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/sur.2024.184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,1]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,5,1]]}},"alternative-id":["10.1089\/sur.2024.184"],"URL":"https:\/\/doi.org\/10.1089\/sur.2024.184","relation":{},"ISSN":["1096-2964","1557-8674"],"issn-type":[{"value":"1096-2964","type":"print"},{"value":"1557-8674","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,1]]}}}