|
KMID : 0385920200310040346
|
|
Journal of the Korean Society of Emergency Medicine
2020 Volume.31 No. 4 p.346 ~ p.354
|
|
|
Association between body temperature measured at the emergency department with prognosis in septic shock patients
|
|
Choi Ju-Hwan
Park Yoo-Seok
Chung Sung-Phil
Shin Tae-Gun
Kim Won-Young
Choi Sung-Hyuk
Jo You-Hwan
Kang Gu-Hyun
Shin Jong-Hwan
Lim Tae-Ho
Han Kap-Su
Suh Gil-Joon
|
|
|
Abstract
|
|
|
Objective: Prior studies have explored the relationship between initial body temperature (BT) and mortality in patients with sepsis in the emergency department (ED). However, there has been no study on whether or not changes in BT are associated with prognosis in these patients. We hypothesize that BT measured upon ED arrival and septic shock registry enroll time are related to the prognosis of patients with septic shock.
Method: We conducted a prospective, observational, registry-based study. Each patient was assigned to 1 of 4 groups according to BT upon ED arrival and registry enrollment. Odds ratios for 28-day mortality according to the patient group were estimated using multivariable logistic regression. We also conducted logistic regression sensitivity analysis, except for patients whose time interval between arrival and enrollment was less than 1 hour.
Results: A total of 2,138 patients with septic shock were included. The 28-day mortalities were 13.7%, 11.2%, 13.0%, and 25.8% in groups 1, 2, 3, and 4, respectively (P<0.001). After adjusting for age, sex, mean atrial pressure, respiratory rate, Sequential Organ Failure Assessment score, lactate concentration, comorbidity, and suspicious infection focus, the risk of mortality was significantly low in patients from group 1 (adjusted odds ratio [aOR], 0.433; 95% confidence interval [CI], 0.310-0.604) and group 2 (aOR, 0.540; 95% CI, 0.336-0.868) compared with group 4. In the sensitivity analysis, group based on BT measured upon ED arrival and registry enrollment also remained an independent predictor of mortality.
Conclusion: Afebrile status upon ED arrival and registry enrollment were strongly associated with higher 28-day mortality in patients with septic shock.
|
|
|
KEYWORD
|
|
|
Septic shock, Body temperature, Mortality, Emergency department
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|