Chesnutt Barbara K, Zamora Martin R, Kleinpell Ruth M
School of Nursing Acute Care Nurse Practitioner Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Am Acad Nurse Pract. 2008 Nov;20(11):539-46. doi: 10.1111/j.1745-7599.2008.00356.x.
To review the fever literature and determine how 38.3 degrees C was deemed the optimal fever threshold that predicts bacteremia.
PubMed, MEDLINE, Cochrane database, and the Cumulative Index to Nursing and Allied Health.
A temperature of 38.3 degrees C has come to be the threshold value that typically triggers diagnostic fever evaluation for bacteremia in hospitalized patients. Studies that define predictors of bacteremia provide conflicting results, and most bacteremia predictor models have not been externally validated. Therefore, current fever guidelines are based on consensus opinion rather than large clinical trials identifying a specific threshold with high sensitivity and a high negative predictive value.
The use of a single temperature threshold of 38.3 degrees C for the prediction of bacteremia is not sufficient in all patients. Additional factors should be considered, including patient population, supporting clinical signs and symptoms, and the patient's medical history.
回顾发热相关文献，确定38.3摄氏度是如何被视为预测菌血症的最佳发热阈值的。
PubMed、MEDLINE、Cochrane数据库以及护理与联合健康累积索引。
38.3摄氏度已成为住院患者菌血症诊断性发热评估的典型触发阈值。定义菌血症预测因素的研究结果相互矛盾，且大多数菌血症预测模型尚未经过外部验证。因此，当前的发热指南基于共识意见，而非通过大型临床试验确定具有高敏感性和高阴性预测价值的特定阈值。
对所有患者而言，仅使用38.3摄氏度这一单一温度阈值来预测菌血症是不够的。应考虑其他因素，包括患者群体、支持性临床体征和症状以及患者的病史。
