Association between first 24-h mean body temperature and mortality in patients with diastolic heart failure in intensive care unit: A retrospective cohort study

Abstract

BackgroundBody temperature (BT) has been used to evaluate the outcomes of patients with various diseases. In this study, patients with diastolic heart failure (DHF) in the intensive care unit (ICU) were examined for a correlation between BT and mortality.MethodsThis was a retrospective cohort study of the Medical Information Mart for Intensive Care (MIMIC)-IV dataset. A total of 4,153 patients with DHF were included. The primary outcomes were 28-day ICU and higher in-hospital mortality rates. BT was used in the analyses both as a continuous variable and as a categorical variable. According to the distribution of BT, the patients were categorized into three groups (hypothermia BT <36.5°C, normal 36.5°C ≤ BT <37.5°C, and hyperthermia BT ≥37.5°C). Multivariate logistic regression analysis was performed to explore the association between BT and patient outcomes.ResultsThe proportions of the groups were 23.6, 69.2, and 7.2%, respectively. As a continuous variable, every 1°C increase in BT was associated with a 21% decrease in 28-day ICU mortality (OR: 0.79, 95% CI: 0.66–0.96, and p = 0.019) and a 23% decrease in in-hospital mortality (OR: 0.77, 95% CI: 0.66–0.91; and p = 0.002). When BT was used as a categorical variable, hypothermia was significantly associated with both 28-day ICU mortality (OR: 1.3, 95% CI: 1.03–1.65; and p = 0.026) and in-hospital mortality (OR: 1.31, 95% CI: 1.07–1.59; and p = 0.008). No statistical differences were observed between 28-day ICU mortality and in-hospital mortality with hyperthermia after adjustment.ConclusionThe first 24-h mean BT after ICU admission was associated with 28-day ICU and in-hospital mortality in patients with DHF. Hypothermia significantly increased mortality, whereas hyperthermia did not.