Admission Body Temperature in Critically Ill Patients as an Independent Risk Predictor for Overall Outcome

被引:22
作者
Erkens, Ralf [1 ,2 ]
Wernly, Bernhard [3 ]
Masyuk, Maryna [1 ,2 ]
Muessig, Johanna M. [1 ,2 ]
Franz, Marcus [4 ]
Schulze, Paul Christian [4 ]
Lichtenauer, Michael [3 ]
Kelm, Malte [1 ,2 ]
Jung, Christian [1 ,2 ]
机构
[1] Heinrich Heine Univ Dusseldorf, Fac Med, Div Cardiol Pulmonol & Vasc Med, Moorenstr 5, DE-40225 Dusseldorf, Germany
[2] Heinrich Heine Univ Dusseldorf, Fac Med, Cardiovasc Res Inst Dusseldorf, CARID, Dusseldorf, Germany
[3] Paracelsus Med Univ Salzburg, Clin Internal Med 2, Dept Cardiol, Salzburg, Austria
[4] Jena Univ Hosp, Clin Internal Med 1, Dept Cardiol, Jena, Germany
关键词
Admission body temperature; Risk stratification; Risk predictor; Critically ill patients; Prognostication; Intensive care unit; INTENSIVE-CARE-UNIT; SEPTIC SHOCK; HYPOTHERMIA; FEVER; MORTALITY; SEPSIS; MANAGEMENT;
D O I
10.1159/000505126
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Body temperature (BT) abnormalities are frequently observed in critically ill patients. We aimed to assess admission BT in a heterogeneous critically ill patient population admitted to an intensive care unit (ICU) as a prognostic parameter for intra-ICU and long-term mortality. Methods: A total of 6,514 medical patients (64 +/- 15 years) admitted to a German ICU between 2004 and 2009 were included. A follow-up of patients was performed retrospectively. The association of admission BT with both intra-ICU and long-term mortality was investigated by logistic regression. Results: Patients with hypothermia (<36 degrees C BT) were clinically worse and had more pronounced signs of multi-organ failure. Admission BT was associated with adverse overall outcome, with a 2-fold increase for hyperthermia (mortality 12%; odds ratio [OR] 1.80, 95% confidence interval [CI] 1.43-2.26; p < 0.001), and a 4-fold increase for the risk of hypothermia (mortality 24%; OR 4.05, 95% CI 3.38-4.85; p < 0.001) with respect to intra-ICU and long-term mortality. Moreover, hypothermia was even more harmful than hyperthermia, and both were strongly associated with intra-ICU mortality, especially in patients admitted with acute coronary syndrome (hypothermia: hazard ratio 6.12, 95% CI 4.12-9.11; p < 0.001; hyperthermia: OR 2.70, 95% CI 1.52-4.79; p< 0.001). Conclusion: Admission BT is an independent risk predictor for both overall intra-ICU and long-term mortality in critically ill patients admitted to an ICU. Therefore, BT at admission might not only serve as a parameter for individual risk stratification but can also influence individual therapeutic decision-making.
引用
收藏
页码:389 / 395
页数:7
相关论文
共 31 条
[1]  
[Anonymous], [No title captured]
[2]   Body temperature alterations in the critically ill [J].
Bota, DP ;
Ferreira, FL ;
Mélot, C ;
Vincent, JL .
INTENSIVE CARE MEDICINE, 2004, 30 (05) :811-816
[3]   HYPOTHERMIA, A PERTINENT CLINICAL PROGNOSTIC FACTOR IN SEVERE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME [J].
BRIVET, F ;
CARRAS, PM ;
DORMONT, J ;
GUIDET, B ;
OFFENSTADT, G ;
GACHOT, B ;
WOLF, M ;
TIMSIT, JF ;
MISSET, B .
CRITICAL CARE MEDICINE, 1994, 22 (03) :533-534
[4]   Thermoregulatory disorders and illness related to heat and cold stress [J].
Cheshire, William P., Jr. .
AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL, 2016, 196 :91-104
[5]   HYPOTHERMIA IN THE SEPSIS SYNDROME AND CLINICAL OUTCOME [J].
CLEMMER, TP ;
METZ, CA ;
GORIS, GB ;
HEARRON, MS ;
SHEAGREN, JN ;
BONE, RC ;
BALK, RA ;
FISHER, CJ ;
ALBERTSON, TE ;
FOULKE, GE ;
MONDRAGON, NK ;
CLEMMER, TP ;
SMITH, JL ;
NYMAN, K ;
SLOTMAN, GJ ;
BURCHARD, KW ;
DAREZZO, A ;
MCLEES, BD ;
MCCALL, CE ;
ALFORD, P ;
JASTREMSKI, MS ;
CHELLURI, L ;
PURI, VK ;
KRUSE, J ;
BOYES, R ;
BANDER, JJ ;
ELLRODT, AG ;
ZELUFF, BJ ;
GENTRY, LO ;
MARTIN, RR ;
SABA, HI ;
BREEN, JF ;
LEIBOWITZ, AI ;
BLACKWOOD, JM ;
MACHIEDO, GW ;
SOTOGREEN, M ;
PLOUFFE, JF ;
SANDERS, CV ;
LYNNBESCH, C ;
DERKS, FW ;
VENEZIO, FR ;
CAPLAN, ES ;
BELZBERG, H ;
DELAPORTAS, D ;
CERRA, FB ;
MANN, HJ ;
PHAIR, JP ;
DAVISON, R ;
THOMAS, FO ;
GOLDSMITH, J .
CRITICAL CARE MEDICINE, 1992, 20 (10) :1395-1401
[6]   Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study [J].
den Hartog, Alexander W. ;
de Pont, Anne-Cornelie J. M. ;
Robillard, Laure B. M. ;
Binnekade, Jan M. ;
Schultz, Marcus J. ;
Horn, Janneke .
CRITICAL CARE, 2010, 14 (03)
[7]   Is body temperature an independent predictor of mortality in hip fracture patients? [J].
Faizi, Murtuza ;
Farrier, Adam J. ;
Venkatesan, Murali ;
Thomas, Christopher ;
Uzoigwe, Chika Edward ;
Balasubramanian, Siva ;
Smith, Robert P. .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2014, 45 (12) :1942-1945
[8]  
Goetzenich A, 2009, J CARDIOVASC SURG, V50, P239
[9]   Surviving intensive care [J].
Kaplan, V ;
Angus, DC .
CRITICAL CARE MEDICINE, 2002, 30 (03) :703-705
[10]   Prolonged Fever After ST-Segment Elevation Myocardial Infarction and Long-Term Cardiac Outcomes [J].
Kawashima, Chika ;
Matsuzawa, Yasushi ;
Akiyama, Eiichi ;
Konishi, Masaaki ;
Suzuki, Hiroyuki ;
Hashiba, Katsutaka ;
Ebina, Toshiaki ;
Kosuge, Masami ;
Hibi, Kiyoshi ;
Tsukahara, Kengo ;
Iwahashi, Noriaki ;
Maejima, Nobuhiko ;
Sakamaki, Kentaro ;
Umemura, Satoshi ;
Kimura, Kazuo ;
Tamura, Kouichi .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2017, 6 (07)