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. 2024 May 15;11(1):e964.
doi: 10.1002/ams2.964. eCollection 2024 Jan-Dec.

Association between the severity of hypothermia and in-hospital mortality in patients with infectious diseases: The J-Point registry

Tadaharu Shiozumi  1 , Yuki Miyamoto  1 , Sachiko Morita  2 , Naoki Ehara  3 , Nobuhiro Miyamae  4 , Yohei Okada  5   6 , Takaaki Jo  7 , Yasuyuki Sumida  4   8 , Nobunaga Okada  1   3   9 , Makoto Watanabe  1 , Masahiro Nozawa  10   11 , Ayumu Tsuruoka  12   13 , Yoshihiro Fujimoto  14 , Yoshiki Okumura  15 , Tetsuhisa Kitamura  16 , Tasuku Matsuyama  1
Affiliations

Association between the severity of hypothermia and in-hospital mortality in patients with infectious diseases: The J-Point registry

Tadaharu Shiozumi et al. Acute Med Surg. .

Abstract

Aim: Hypothermia is associated with poor prognosis in patients with sepsis. However, no studies have explored the correlation between the severity of hypothermia and prognosis.

Methods: Using data from the Japanese accidental hypothermia network registry (J-Point registry), we examined adult patients aged ≥18 years with infectious diseases whose initial body temperature was ≤35°C from April 1, 2011 to March 31, 2016, in 12 centers. Patients were divided into three groups according to their body temperature: Tertile 1 (T1) (32.0-35.0°C), Tertile 2 (T2) (28.0-31.9°C), and Tertile 3 (T3) (<28.0°C). In-hospital mortality was employed as a metric to assess outcomes. We conducted a multivariate logistic regression analysis to investigate the relationship between the three categories and the occurrence of in-hospital mortality.

Results: A total of 572 patients were registered, and 170 eligible patients were identified. Of these patients, 55 were in T1 (32.0-35.0°C), 76 in T2 (28.0-31.9°C), and 39 in T3 (<28.0°C) groups. The overall in-hospital mortality rate in accidental hypothermia (AH) patients with infectious diseases was 34.1%. The in-hospital mortality rates in the T1, T2, and T3 groups were 34.5%, 36.8%, and 28.2%, respectively. The multivariable analysis demonstrated no significant differences regarding in-hospital mortality among the three groups (T2 vs. T1, adjusted odds ratio [OR]: 1.29; 95% confidence interval [CI]: 0.58-2.89 and T3 vs. T1, adjusted OR: 0.83; 95% CI: 0.30-2.31).

Conclusion: In this multicenter retrospective observational study, hypothermia severity was not associated with in-hospital mortality in AH patients with infectious diseases.

Keywords: accidental hypothermia; emergency department; environmental medicine; infection; mortality.

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Conflict of interest statement

YO has received a research grant from the ZOLL Foundation and overseas scholarships from the Japan Society for Promotion of Science, the FUKUDA Foundation for Medical Technology, and the International Medical Research Foundation. These organizations have no role in conducting this study.

Figures

FIGURE 1
FIGURE 1
Patient flow of this study. AH, accidental hypothermia; J‐Point, Japanese accidental hypothermia network.
FIGURE 2
FIGURE 2
Multivariate logistic regression analysis demonstrated that the factors associated with in‐hospital death were age ≥75 years, and unstable hemodynamic status. T1, 32.0–35.0°C; T2, 28.0–31.9°C; T3, <28.0°C.
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