Medical Scientist Training Program (MSTP), United States of America.
Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, United States of America.
Am J Emerg Med. 2020 May;38(5):929-933. doi: 10.1016/j.ajem.2019.158355. Epub 2019 Jul 18.
A patient's vital signs are all inextricably interrelated, and together provide critical information regarding hemodynamic and physiological status. Yet, the precise relationship between body temperature (T) and heart rate (HR) in adults remains a fundamental gap in our knowledge.
We performed a retrospective secondary analysis of (1) electronic medical records from a large academic center (annual ED census of 110,000) and (2) the National Hospital Ambulatory Medical Care Survey (NHAMCS), a large CDC-sponsored weighted sample of U.S. EDs and our own large tertiary care ED, extracting demographic and clinical data including vital signs.
We included 8715 local ED visits and approximately 123.3 million estimated national adult ED visits. Mean T was 36.9 °C, and 5.2% of patients had a T over 38 °C. Mean (SD) HR was 93.3 bpm, 28% had a HR over 100 bpm. Males had significantly lower HR than females (coefficient -1.6, 95%CI -2.4 to -0.8), while age was negatively associated with HR (coefficient -0.08, 95%CI -0.10 to -0.06). For national data, an increase of 1 °C in T corresponded to an increase in HR of 7.2 bpm (95%CI 6.2 to 8.3). After adjusting for age and gender, a 1 °C increase in T corresponded to a mean (95%CI) 10.4 (9.5-11.4) and 6.9 (5.9-7.8) increase in HR locally and nationally, respectively.
Among adult ED patients nationally, for every increase in T of 1 °C, the HR increases by approximately 7 bpm.
患者的生命体征是相互关联的,共同提供有关血流动力学和生理状态的关键信息。然而,成年人的体温(T)和心率(HR)之间的确切关系仍然是我们知识中的一个基本空白。
我们对(1)大型学术中心的电子病历(每年急诊就诊人数为 11 万)和(2)全国医院门诊医疗调查(NHAMCS)进行了回顾性二次分析,这是一项由 CDC 赞助的美国急诊和我们自己的大型三级保健急诊的大型加权样本,提取了人口统计学和临床数据,包括生命体征。
我们纳入了 8715 例当地急诊就诊和大约 12330 万例估计的全国成年急诊就诊。平均 T 为 36.9°C,5.2%的患者 T 超过 38°C。平均(SD)HR 为 93.3 bpm,28%的患者 HR 超过 100 bpm。男性的 HR 明显低于女性(系数-1.6,95%CI-2.4 至-0.8),而年龄与 HR 呈负相关(系数-0.08,95%CI-0.10 至-0.06)。对于全国数据,T 升高 1°C 对应 HR 升高 7.2 bpm(95%CI 6.2 至 8.3)。在调整年龄和性别后,T 升高 1°C 分别对应当地和全国 HR 的平均(95%CI)增加 10.4(9.5-11.4)和 6.9(5.9-7.8)。
在全国范围内的成年急诊患者中,T 每升高 1°C,HR 升高约 7 bpm。