A Dignostic Model To Early Differentiate Infectious And Noninfectious Diseases In Hospitalized Patients With Fever

Background:Febrile diseases have a variety of etiologies.To establish a simple and feasible model to differentiate infectious and noninfectious diseases in patients hospitalized for fever may aid the physicians to immediately initiate prompt further diagnostic strategy and treatment.Objectives:This study was designed to analyze the distribution of causes in patients hospitalized with fever and establish a simple and feasible model to differentiate infectious and noninfectious diseases in patients hospitalized for fever.Methods:We investigated 360 patients hospitalized at Drum Tower Hospital Affiliated to Nanjing medical University,Nanjing,China between August 2016 and January 2018 for fever without any causal diagnosis.Of all the cases,infectious diseases accounted for 66.7%,noninfectious diseases for 18.6%,and no diagnosis for 14.7%.We analyzed a number of characteristics measured for the first time after admission.Results:Patients with fever for not more than one week before hospitalization,the infectious group had,indeed,significantly higher proportion than the noninfectious group(34.6%vs.10.4%).Meanwhile,fever lasting for more than 21 days before hospitalization,the noninfectious group had more possibility than the infectious group(46.3%vs.21.7%)(P<0.001).The patients with chills and complicated with type 2 diabetes melitus in infectious group were greater compared with those in noninfectious group(P<0.05).Compared to the infectious disease group,the WBC,M,Hb,BG were identified to be significantly lower in the noninfectious disease group,whereas the PLT,FER,ESR,AKP,GLB values were significantly higher(P<0.05).Multivariate regression analyses indicated that the WBC(OR,0.8789;95%CI,0.8095-0.9542;P=0.002),Hb(OR,0.9742;95%CI,0.9598-0.9888;P=0.001),PLT(OR,1.0089;95%CI,1.0052-1.0126;P<0.001)and FER(OR,1.0002;95%CI,1.0001-1.0003;P<0.001)were the independent risk factors for differential infectious and noninfectious disease of patients with fever on admission.We established a simple and feasible model which differentiates infectious and noninfectious diseases in patients hospitalized for fever with high sensitivity and specificity.Conclusion:The model we established differentiates infectious and noninfectious diseases in patients hospitalized for fever with high sensitivity and specificity.This model may aid the physicians to immediately initiate prompt further diagnostic strategy and treatment.