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. 2023 Dec 20;28(1):614.
doi: 10.1186/s40001-023-01584-8.

Low body temperature and mortality in critically ill patients with coronary heart disease: a retrospective analysis from MIMIC-IV database

Weiran Luo  1 , Lixue Cao  2 , Chuan Wang  3
Affiliations

Low body temperature and mortality in critically ill patients with coronary heart disease: a retrospective analysis from MIMIC-IV database

Weiran Luo et al. Eur J Med Res. .

Abstract

Background: This study was aimed to investigate the correlation between low body temperature and outcomes in critically ill patients with coronary heart disease (CHD).

Methods: Participants from the Medical Information Mart for Intensive Care (MIMIC)-IV were divided into three groups (≤ 36.5 ℃, 36.6-37.4 ℃, ≥ 37.5 ℃) in accordance with body temperature measured orally in ICU. In-hospital, 28-day and 90-day mortality were the major outcomes. Multivariable Cox regression, decision curve analysis (DCA), restricted cubic splines (RCS), Kaplan-Meier curves (with or without propensity score matching), and subgroup analyses were used to investigate the association between body temperature and outcomes.

Results: A total of 8577 patients (65% men) were included. The in-hospital, 28-day, 90-day, and 1-year overall mortality rate were 10.9%, 16.7%, 21.5%, and 30.4%, respectively. Multivariable Cox proportional hazards regression analyses indicated that patients with hypothermia compared to the patients with normothermia were at higher risk of in-hospital [adjusted hazard ratios (HR) 1.23, 95% confidence interval (CI) 1.01-1.49], 28-day (1.38, 1.19-1.61), and 90-day (1.36, 1.19-1.56) overall mortality. For every 1 ℃ decrease in body temperature, adjusted survival rates were likely to eliminate 14.6% during the 1-year follow-up. The DCA suggested the applicability of the model 3 in clinical practice and the RCS revealed a consistent higher mortality in hypothermia group.

Conclusions: Low body temperature was associated with increased mortality in critically ill patients with coronary heart disease.

Keywords: Body temperature; Clinical outcome; Coronary heart disease; Intensive care unit.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The decision curve analysis (DCA) to evaluate the predictive power of multiple models. A The DCA for in-hospital mortality; B the DCA for 28-day mortality; C the DCA for 90-day mortality
Fig. 2
Fig. 2
Association between body temperature and outcomes of critically ill patients with CHD. Restricted cubic spline for unadjusted in-hospital mortality (A), 28-day mortality (B), 90-day mortality (C) and adjusted in-hospital mortality (D), 28-day mortality (E), 90-day mortality (F). CI, confidence interval; HR, hazard ratio
Fig. 3
Fig. 3
Kaplan–Meier curves of cumulative event-free survival of all-cause death in different groups. Groups were divided by body temperature (℃) in three groups (hypothermia: ≤ 36.5 ℃, normothermia: 36.6–37.4℃, hyperthermia: ≥ 37.5 ℃) unadjusted (A) and adjusted by propensity score matching (B)
See this image and copyright information in PMC

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