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Journal of Intensive Care Medicine
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*Fever
*Traumatic Brain Injury
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Brain Injury and Fever: Hospital Length of Stay and Cost Outcomes

Nancy L. Reaven, MA

Strategic Health Resources, La Canada California, nancy.reaven{at}strathealth.com

Joseph E. Lovett, PhD

Strategic Health Resources, La Canada California

Susan E. Funk, MBA

Strategic Health Resources, La Canada California

Fever has been shown to be related to extended hospital stays in neurologically injured patients. We performed meta-analyses of the impact of fever on length of stay (LOS) in the Intensive Care Unit (ICU) and for total hospital length of stay, including all recent scholarship published since 1/1/1995 pertaining to thermoregulation of neurogenic fever and length of hospital stay. We also developed estimates of the financial impact on hospital costs. Fever was shown to have a large, statistically significant impact on both ICU and hospital LOS. For ICU LOS, combined effect size g = .88, Z = 4.24, P < .0001. For hospital LOS, g = .79, Z = 2.2, P = .0278. Mean additional ICU days = 5.7 days; mean additional hospital days = 8.5 days. We estimate that fever added an average of $17,414 in hospital cost to total hospital stays; mean $13,672 (95% Confidence Interval [CI]: $10,074, $17,270) in additional ICU costs and mean $3,742 (CI: —$1,203, $8,820) in additional routine costs.

Key Words: traumatic brain injury • subarachnoid hemorrhage • length of stay • cost • hyperthermia

This version was published on March 1, 2009

Journal of Intensive Care Medicine, Vol. 24, No. 2, 131-139 (2009)
DOI: 10.1177/0885066608330211
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