BACKGROUND: Sepsis is usually accompanied by changes of body temperature (Tb), but
whether fever and hypothermia predict mortality equally or differently is not fully
clarified. We aimed to find an association between Tb and mortality in septic patients
with meta-analysis of clinical trials. METHODS: We searched the PubMed, EMBASE, and
Cochrane Controlled Trials Registry databases (from inception to February 2016). Human
studies reporting Tb and mortality of patients with sepsis were included in the analyses.
Average Tb with SEM and mortality rate of septic patient groups were extracted by
two authors independently. RESULTS: Forty-two studies reported Tb and mortality ratios
in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative
linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis,
we found a 22.2% (CI, 19.2-25.5) mortality rate in septic patients with fever (Tb
> 38.0 degrees C), which was higher, 31.2% (CI, 25.7-37.3), in normothermic patients,
and it was the highest, 47.3% (CI, 38.9-55.7), in hypothermic patients (Tb < 36.0
degrees C). Meta-regression analysis showed strong negative linear correlation between
Tb and mortality rate (regression coefficient: -0.4318; P < 0.001). Mean Tb of the
patients was higher in the lowest mortality quartile than in the highest: 38.1 degrees
C (CI, 37.9-38.4) vs 37.1 degrees C (CI, 36.7-37.4). CONCLUSIONS: Deep Tb shows negative
correlation with the clinical outcome in sepsis. Fever predicts lower, while hypothermia
higher mortality rates compared with normal Tb. Septic patients with the lowest (<
25%) chance of mortality have higher Tb than those with the highest chance (> 75%).
