Unraveling quad fever:Severe hyperthermia after traumatic cervical spinal cord injury  

作　　者：Carlton C.L.Watson Dooniya Shaikh Jody C.DiGiacomo Aaron C.Brown Raina Wallace Shridevi Singh Lisa Szydziaka Sara Cardozo-Stolberg LD.George Angus 

机构地区：[1]Department of Surgery,Nassau University Medical Center,East Meadow,NY,1155,USA [2]American University of the Caribbean School of Medicine,Pembroke Pines,FL,33027,USA

出　　处：《Chinese Journal of Traumatology》2023年第1期27-32,共6页中华创伤杂志（英文版）

基　　金：This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors.

摘　　要：Purpose:There are many infectious and inflammatory causes for elevated core-body temperatures,though they rarely pass 40℃(104℉).The term"quad fever"is used for extreme hyperpyrexia in the setting of acute cervical spinal cord injuries(SCIs).The traditional methods of treating hyperpyrexia are often ineffective and reported morbidity and mortality rates approach 100%.This study aims to identify the incidence of elevated temperatures in SCIs at our institution and assess the effectiveness of using a non-invasive dry water temperature management system as a treatment modality with mortality.Methods:A retrospective analysis of acute SCI patients requiring surgical intensive care unit admission who experienced fevers≥40℃(104℉)were compared to patients with maximum temperatures<40℃.Patients≥18 years old who sustained an acute traumatic SCI were included in this study.Patients who expired in the emergency department;had a SCI without radiologic abnormality;had neuropraxia;were admitted to any location other than the surgical intensive care unit;or had positive blood cultures were excluded.SAS 9.4 was used to conduct statistical analysis.Results:Over the 9-year study period,35 patients were admitted to the surgical intensive care unit with a verified SCI.Seven patients experienced maximum temperatures of≥40℃.Six of those patients were treated with the dry water temperature management system with an overall mortality of 57.1%in this subgroup.The mortality rate for the 28 patients who experienced a maximum temperature of≤40℃was 21.4%(p=0.16).Conclusion:The diagnosis of quad fever should be considered in patients with cervical SCI in the presence of hyperthermia.In this study,there was no significant difference in mortality between quad fever patients treated with a dry water temperature management system versus SCI patients without quad fever.The early use of a dry water temperature management system appears to decrease the mortality rate of quad fever.

关 键 词：Spinal cord injuries FEVER QUADRIPLEGIA Therapeutic hypothermia 

分 类 号：R651.2[医药卫生—外科学]