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Three Part Question

In [adult patients with diagnosed acute pericarditis] is [pyrexia] an [accurate predictor of high risk patients]

Search Strategy

MEDLINE: Via Ovid Interface. [Exp pericarditis/ or pericard$.mp] AND [exp pyrexia OR pyrexia$.mp OR exp fever OR temperature.mp] NOT [Case report.mp or case study.mp]. Limit to Humans and English Language.

EMBASE: Via Ovid Interface. [Exp pericarditis/ or pericard$.mp] AND [exp pyrexia OR pyrexia$.mp OR exp fever OR temperature.mp] NOT [Case report.mp or case study.mp] AND [exp high risk patient]. Limit to Humans and English Language.

COCHRANE: Pericarditis AND Fever
7 papers were identified through EMBASE, 40 through MEDLINE, and 0 through The Cochrane Library. One of these results one was relevant to the three-part question.

Search Outcome

There has been minimal published literature that confronts this three-part question. However, the one study that was identified provided direct data to support the question. Patients with acute pericarditis who are pyretic should be considered high-risk because this is an identifiable sign of poor prognosis (Other risk factors are cardiac tamponade, large pericardial effusion, immunosuppression, oral anticoagulation therapy history, acute trauma, failure to respond within 7 days of NSAID therapy, elevated troponin, and previous MI). Due to the high-rate of identifiable specific causes in these patients, they should be considered high-risk and therefore admitted to hospital.

Clinical Bottom Line

There has been minimal published literature that confronts this three-part question. However, the one study that was identified provided direct data to support the question. Patients with acute pericarditis who are pyrexic should be considered high-risk because this is an identifiable sign of poor prognosis (Other risk factors are cardiac tamponade, large pericardial effusion, immunosuppression, oral anticoagulation therapy history, acute trauma, failure to respond within 7 days of NSAID therapy, elevated troponin, and previous MI). Due to the high-rate of identifiable specific causes in these patients, they should be considered high-risk and therefore admitted to hospital.