McAlpine C H, Martin B J, Lennox I M, Roberts M A
Age Ageing. 1986 Jul;15(4):230-4. doi: 10.1093/ageing/15.4.230.
This prospective study investigated the common belief that pyrexia is frequently absent in elderly patients with infection. Oral temperature was closely monitored using both a mercury and an electronic thermometer in 150 ill elderly patients (mean age 81 years) of whom 80% were new admissions to this Unit. A scoring system was devised, based on investigation results and excluding temperature, to assess objectively the likelihood of infection. Seventy-one patients (47%) had 'definite' infection: 95% were pyrexial. A further eight of the nine patients with probable infection were pyrexial. There were no significant differences in mean temperature or other indices of infection between those who died of their infection and those who survived. Ten per cent of all pyrexias were detected only on the electronic thermometer, not on mercury measurement. In 12% of pyrexial patients, the pyrexia first appeared more than 12 h after temperature measurement started. With effective monitoring, pyrexia is detectable in the vast majority of infected elderly patients.
这项前瞻性研究调查了一种普遍看法，即感染的老年患者常常不出现发热症状。对150名患病老年患者（平均年龄81岁）使用水银体温计和电子体温计密切监测口腔温度，其中80%是首次入住本病房的患者。基于调查结果并排除体温因素，设计了一个评分系统，以客观评估感染的可能性。71名患者（47%）有“确诊”感染：95%发热。另外9名可能感染的患者中有8名发热。死于感染的患者和存活患者之间的平均体温或其他感染指标没有显著差异。所有发热病例中有10%仅通过电子体温计检测到，水银体温计未测到。在12%的发热患者中，发热在开始测量体温12小时后才首次出现。通过有效监测，绝大多数感染的老年患者都能检测出发热。
