title: Body Temperature at the Emergency Department as a Predictor of Mortality in Patients With Bacterial Infection.
abstract: Hypothermia is a risk factor for death in intensive care unit (ICU) patients with severe sepsis and septic shock. In the present study, we investigated the association between body temperature (BT) on arrival at the emergency department (ED) and mortality in patients with bacterial infection.We conducted a retrospective cohort study in consecutive ED patients over 15 years of age with bacterial infection who were admitted to an urban teaching hospital in Japan between 2010 and 2012. The main outcome measure was 30-day in-hospital mortality. Each patient was assigned to 1 of 6 categories based on BT at ED admission. We conducted multivariable logistic regression analysis to adjust for predictors of death.A total of 913 patients were enrolled in the study. The BT categories were <36, 36 to 36.9, 37 to 37.9, 38 to 38.9, 39 to 39.9, and ≥40 °C, with respective mortalities of 32.5%, 14.1%, 8.7%, 8.2%, 5.7%, and 5.3%. Multivariable analysis showed that the risk of death was significantly low in patients with BT 37 to 37.9 °C (adjusted odds ratio [AOR]: 0.2; 95% confidence interval [CI] 0.1-0.6, P = 0.003), 38-38.9 °C (AOR: 0.2; 95% CI 0.1-0.6, P = 0.002), 39-39.9 °C (AOR: 0.2; 95% CI 0.1-0.5, P = 0.001), and ≥40 °C (AOR: 0.1; 95% CI 0.02-0.4, P = 0.001), compared with hypothermic patients (BT <36 °C).The higher BT on arrival at ED, the better the outcomes observed in patients with bacterial infection were.
authors.affiliation: From the Department of Healthcare Epidemiology (SY, SY, TT, SF, YY, SF), School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto; Division of Infectious Diseases (SY), Kobe University Hospital, Hyogo; Current affiliation: Center for Environmental Health Sciences (SY), National Institute for Environmental Studies, Ibaraki; Department of Infectious Diseases (TS, KT, YT, KS), Kyoto City Hospital, Kyoto; Division of Community and Family Medicine (TT), Center for Community Medicine, Jichi Medical University, Tochigi; Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE) (SF, SF), Fukushima Medical University, Fukushima; Department of Clinical Laboratory Medicine (current affiliation for YT), Graduate School of Medicine, Kyoto University, Kyoto; and Disease Control and Prevenion Center (current affiliation for KS), National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shungo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Shin
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Shimizu
authors.forename: Taro
authors.initials: T
authors.lastname: Takeshima
authors.forename: Shingo
authors.initials: S
authors.lastname: Fukuma
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tochitani
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsuchido
authors.forename: Koh
authors.initials: K
authors.lastname: Shinohara
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000401:mortality*; D001831:Body Temperature; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality*; D012720:Severity of Illness Index; D012737:Sex Factors; D012772:Shock, Septic / Q000401:mortality; D012959:Socioeconomic Factors