Skip to main content

Increased short-term mortality among normothermic patients presenting to a medical emergency department with infection - a cohort study


Infections are frequent causes of medical admissions to the emergency department (ED). However, not all infected patients present with fever (>38°C). The aim of the study was to assess differences in short-term mortality among patients hospitalized with community-acquired infection presenting with and without fever.


All adult patients (≥15 years) with a first-time admission at a medical ED between September 2010-August 2011 with community-acquired infection were included. Cases were identified by manual chart review using predefined criteria of infection. Data on vital signs, laboratory values and antibiotic treatment were obtained electronically. We excluded unidentified patients and patients residing outside the hospitals catchment area. To assess if the absence of fever (normothermia: 36.0-38.0°C) is an independent prognostic factor, we computed multiple Cox regression analyses, adjusted for different potential confounders.


1,901 patients with infection, treated with antibiotics within 24 hours after arrival, were included. Median age was 74 years (5-95% range: 29-92 years); 896 (47.1%) were males, and 811 (42.7%) presented with a Charlson Comorbidity Index >2; 49.7% were normothermic at arrival and 50.3% presented with fever. Thirty-day mortality was 9.3% (95% CI: 7.5-11.3%) among patients with fever and 18.1% (95% CI: 15.7-20.7%) in normothermic patients. The unadjusted hazard ratio (HR) of death within 30 days after admission in normothermic infectious patients was 2.2 (95% CI: 1.7-2.8) compared to infectious patients with fever, adjusted HR 2.0 (95% CI: 1.6-2.6).


Normothermic patients admitted with an infection were twice as likely to die within 30 days after admission compared to infectious patients admitted with fever.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Daniel P Henriksen.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Henriksen, D.P., Jensen, H.C., Laursen, C.B. et al. Increased short-term mortality among normothermic patients presenting to a medical emergency department with infection - a cohort study. Scand J Trauma Resusc Emerg Med 23 (Suppl 1), A26 (2015).

Download citation

  • Published:

  • DOI: