体温是髋部骨折患者死亡率的独立预测因素吗？
Is body temperature an independent predictor of mortality in hip fracture patients?
作者信息
Faizi Murtuza, Farrier Adam J, Venkatesan Murali, Thomas Christopher, Uzoigwe Chika Edward, Balasubramanian Siva, Smith Robert P
出版信息
Injury. 2014 Dec;45(12):1942-5. doi: 10.1016/j.injury.2014.09.024.
INTRODUCTION
Admission body temperature is a critical parameter in all trauma patients. Low admission temperature is strongly associated with adverse outcomes. We have previously shown, in a prospective study that low admission body temperature is common and associated with high mortality in hip fracture patients (Uzoigwe et al., 2014). However, no previous studies have evaluated whether admission temperature is an independent predictor of mortality in hip fracture patients after adjustment for the 7 recognised independent prognostic indicators (Maxwell et al., 2008).
METHODS
We retrospectively collated data on all patients presenting to our institution between June 2011 and February 2013 with a hip fracture. This included patients involved in the original prospective study (Uzoigwe et al., 2014). Admission tympanic temperature, measured on initial presentation at triage, was recorded. The prognosticators of age, gender, source of admission, abbreviated mental test score, haemoglobin, co-morbid disease and the presence or absence of malignancy were also recorded. Using multiple logistic regression, adjustment was made for these potentially confounding prognostic indicators of 30-day mortality, to determine if admission low body temperature were independently linked to mortality.
RESULTS
1066 patients were included. 781 patients, involved in the original prospective study (Uzoigwe et al., 2014), presented in the relevant time frame and were included in the retrospective study. The mean age was 81. There were 273 (26%) men and 793 (74%) women. 407 (38%) had low body temperature (<36.5 °C). Adjustment was made for age, gender, source of admission, abbreviated mental test score, haemoglobin, co-morbid disease and the presence or absence of malignancy. Those with low body temperature had an adjusted odds ratio of 30-day mortality that was 2.1 times that of the euthermic (36.5–37.5 °C).
CONCLUSIONS
Low body temperature is strongly and independently associated with 30-day mortality in hip fracture patients.
引言
入院体温是所有创伤患者的关键参数。低入院体温与不良预后密切相关。我们之前在一项前瞻性研究中表明，低入院体温在髋部骨折患者中很常见，且与高死亡率相关（乌佐伊格韦等人，2014年）。然而，之前没有研究评估过在调整了7个公认的独立预后指标后（麦克斯韦等人，2008年），入院体温是否是髋部骨折患者死亡率的独立预测因素。
方法
我们回顾性整理了2011年6月至2013年2月期间在我们机构就诊的所有髋部骨折患者的数据。这包括参与原始前瞻性研究的患者（乌佐伊格韦等人，2014年）。记录了在分诊时首次就诊时测量的入院鼓膜温度。还记录了年龄、性别、入院来源、简易精神测试评分、血红蛋白、合并疾病以及是否存在恶性肿瘤等预后因素。使用多元逻辑回归，对这些可能混淆30天死亡率的预后指标进行调整，以确定入院低体温是否与死亡率独立相关。
结果
共纳入1066例患者。781例参与原始前瞻性研究的患者（乌佐伊格韦等人，2014年）在相关时间范围内就诊并被纳入回顾性研究。平均年龄为81岁。有273名男性（26%）和793名女性（74%）。407例（38%）体温较低（<36.5°C）。对年龄、性别、入院来源、简易精神测试评分、血红蛋白、合并疾病以及是否存在恶性肿瘤进行了调整。体温较低者30天死亡率的调整优势比是体温正常者（36.5 - 37.5°C）的2.1倍。
结论
低体温与髋部骨折患者的30天死亡率密切且独立相关。
Zotero 插件