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外科重症监护病房术后即刻体温与1年死亡率的关联:使用数字腋温计的回顾性分析

Association of Immediate Postoperative Temperature in the Surgical Intensive Care Unit with 1-Year Mortality: Retrospective Analysis Using Digital Axillary Thermometers.

作者信息

Kim Jiwook, Oh Tak Kyu, Lee Jaebong, Kim Saeyeon, Song In-Ae

机构信息

Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Acute Crit Care. 2019 Feb;34(1):53-59. doi: 10.4266/acc.2019.00255. Epub 2019 Jan 9.

Abstract

BACKGROUND

Postoperative body temperature is closely associated with prognosis although there is limited research regarding this association at Postoperative intensive care unit (ICU) admission. Furthermore, no studies have used digital axillary thermometers to measure Postoperative body temperature. This study investigated the association between mortality and Postoperative temperature measured using a digital axillary thermometer within 10 minutes after ICU admission.

METHODS

This retrospective observational study evaluated data from adult patients admitted to an ICU after elective or emergency surgery. The primary outcome was 1-year mortality after ICU admission. Multivariable logistic regression analysis with restricted cubic splines was used to evaluate the association between temperature and outcomes.

RESULTS

We evaluated data from 5,868 patients admitted between January 1, 2013 and May 31, 2016, including 5,311 patients (90.5%) who underwent noncardiovascular surgery and 557 patients (9.5%) who underwent cardiovascular surgery. Deviation from the median temperature (36.6℃) was associated with increases in 1-year mortality (≤ 36.6℃: linear coefficient, -0.531; P<0.001 and ≥36.6℃: spline coefficient, 0.756; P<0.001). Similar statistically significant results were observed in the noncardiovascular surgery group, but not in the cardiovascular surgery group.

CONCLUSIONS

An increase or decrease in body temperature (vs. 36.6℃) measured using digital axillary thermometers within 10 minutes of Postoperative ICU admission was associated with increased 1-year mortality. However, no significant association was observed after cardiovascular surgery. These results suggest that Postoperative temperature is associated with longterm mortality in patients admitted to the surgical ICU in the Postoperative period.

摘要

背景

术后体温与预后密切相关,尽管关于术后重症监护病房(ICU)入院时这种关联的研究有限。此外,尚无研究使用数字腋温计测量术后体温。本研究调查了ICU入院后10分钟内使用数字腋温计测量的术后体温与死亡率之间的关联。

方法

这项回顾性观察性研究评估了择期或急诊手术后入住ICU的成年患者的数据。主要结局是ICU入院后1年的死亡率。采用受限立方样条的多变量逻辑回归分析来评估体温与结局之间的关联。

结果

我们评估了2013年1月1日至2016年5月31日期间入院的5868例患者的数据,其中包括5311例(90.5%)接受非心血管手术的患者和557例(9.5%)接受心血管手术的患者。与中位体温(36.6℃)的偏差与1年死亡率的增加相关(≤36.6℃:线性系数,-0.531;P<0.001;≥36.6℃:样条系数,0.756;P<0.001)。在非心血管手术组中观察到了类似的统计学显著结果,但在心血管手术组中未观察到。

结论

术后ICU入院后10分钟内使用数字腋温计测量的体温升高或降低(与36.6℃相比)与1年死亡率增加相关。然而,心血管手术后未观察到显著关联。这些结果表明,术后体温与术后入住外科ICU患者的长期死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a258/6849047/5b98ae2d5a27/acc-2019-00255f1.jpg

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