Admission body temperature in critical ill patients as an independent risk predictor for overall outcome.

Erkens, Ralf; Wernly, Bernhard; Masyuk, Maryna; Muessig, Johanna; Franz, Marcus; Schulze, Paul C; Lichtenauer, Michael; Kelm, Malte; Jung, Christian

SIGNIFICANCE Body temperature (BT) abnormalities are frequently observed in critically ill patients. We aimed to assess admission BT in a heterogeneous medical critically ill patient population admitted to an intensive care unit (ICU) as new prognostic parameter for intra-ICU and long-term mortality. METHODS A total of 6514 medical patients (64 ± 15 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively. Association of admission BT and both intra-ICU and long-term mortality were investigated by logistic regression respectively. RESULTS Patients with hypothermia (<36°C BT) were clinically sicker 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%; OR 1.80 95%CI 1.43-2.26; p<0.001) and a 4-fold increase in risk for 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 as hyperthermia and both were strongly associated with intra-ICU mortality, especially in patients admitted with acute coronary syndrome (hypothermia: (HR 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 constitute as a parameter for individual risk stratification but can also influence individual therapeutic decision making.