Abstract
Aim: To evaluate the relationship between clinical features
evaluated at admission to the emergency department (ED) and the presence
of infection on thoracic and abdominal tomography (CT) scans in patients
with acute febrile illness without clinical clues.
Methods: Patients aged 18 years and over who presented to ED
with acute fever between January 1, 2020 and December 31, 2020 and
underwent CT imaging (thoracic and abdomen) as a diagnostic test CT)
were included in the study retrospectively. The patients were divided
into two groups according to the presence and absence of a source of
infection on CT. The clinical and demographic data of the patients were
evaluated. The effect of clinical factors on the presence of infection
in CT scans was determined using the logistic regression analysis.
Results: Among the 173 patients included in the study, the CT
scans were positive for the source of infection in 31.2% (n=54) and
negative in 68.8% (n=119). In the multiple logistic regression
analysis, age ≥ 65 years [odds ratio (OR):2.72, 95% confidence
interval (CI):1.15-4.35, p<0.001), presence of comorbidity
(OR:2.37, 95% CI:1.08-4.14, p=0.033), and procalcitonin positivity
(PCT) (OR:2.54, 95% CI:1.29-4.95, p=0.006) were identified as risk
factors for the presence of infection in CT.
Conclusion: Age, presence of comorbidity, and PCT level should
be considered when deciding on the use of CT in determining the source
of infection in acute febrile patients without clinical clues.
Keywords: Acute fever, Emergency department, Infection,
Tomography