Author:
Tan Daniel J.,Chen Jiayang,Zhou Yirui,Ong Jaryl Shen Quan,Sin Richmond Jing Xuan,Bui Thach V.,Mehta Anokhi Amit,Feng Mengling,See Kay Choong
Abstract
Abstract
Background
Body temperature (BT) is routinely measured and can be controlled in critical care settings. BT can impact patient outcome, but the relationship between BT and mortality has not been well-established.
Methods
A retrospective cohort study was conducted based on the MIMIC-IV (N = 43,537) and eICU (N = 75,184) datasets. The primary outcome and exposure variables were hospital mortality and first 48-h median BT, respectively. Generalized additive models were used to model the associations between exposures and outcomes, while adjusting for patient age, sex, APS-III, SOFA, and Charlson comorbidity scores, temperature gap, as well as ventilation, vasopressor, steroids, and dialysis usage. We conducted subgroup analysis according to ICU setting, diagnoses, and demographics.
Results
Optimal BT was 37 °C for the general ICU and subgroup populations. A 10% increase in the proportion of time that BT was within the 36–38 °C range was associated with reduced hospital mortality risk in both MIMIC-IV (OR 0.91; 95% CI 0.90–0.93) and eICU (OR 0.86; 95% CI 0.85–0.87). On the other hand, a 10% increase in the proportion of time when BT < 36 °C was associated with increased mortality risk in both MIMIC-IV (OR 1.08; 95% CI 1.06–1.10) and eICU (OR 1.18; 95% CI 1.16–1.19). Similarly, a 10% increase in the proportion of time when BT > 38 °C was associated with increased mortality risk in both MIMIC-IV (OR 1.09; 95% CI 1.07–1.12) and eICU (OR 1.09; 95% CI 1.08–1.11). All patient subgroups tested consistently showed an optimal temperature within the 36–38 °C range.
Conclusions
A BT of 37 °C is associated with the lowest mortality risk among ICU patients. Further studies to explore the causal relationship between the optimal BT and mortality should be conducted and may help with establishing guidelines for active BT management in critical care settings.
Funder
A*STAR, CISCO Systems (USA) Pte. Ltd and National University of Singapore under its Cisco-NUS Accelerated Digital Economy Corporate Laboratory
Publisher
Springer Science and Business Media LLC
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