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体温与 ICU 中合并糖尿病的充血性心力衰竭患者住院死亡率的关系:一项回顾性队列研究。

Association Between Body Temperature and In-Hospital Mortality Among Congestive Heart Failure Patients with Diabetes in Intensive Care Unit: A Retrospective Cohort Study.

机构信息

Cardiovascular Surgery Department, The Second Hospital of Jilin University, Changchun, China.

Department of Ophthalmology, First Hospital of Jilin University, Changchun, China.

出版信息

Ther Hypothermia Temp Manag. 2024 Sep;14(3):197-204. doi: 10.1089/ther.2023.0053. Epub 2023 Nov 15.

DOI:10.1089/ther.2023.0053
PMID:37971393
Abstract

Body temperature (BT) has been utilized to assess patient outcomes across various diseases. However, the impact of BT on mortality in the intensive care unit (ICU) among patients with congestive heart failure (CHF) and diabetes mellitus (DM) remains unclear. We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care (MIMIC)-IV data set. The primary outcome assessed was in-hospital mortality rates. BT was treated as a categorical variable in the analyses. The association between BT on ICU admission and in-hospital mortality was examined using multivariable logistic regression models, restricted cubic spline, and subgroup analysis. The cohort comprised 7063 patients with both DM and CHF (3135 females and 3928 males), with an average age of 71.5 ± 12.2 years. Comparative analysis of the reference group (Q4) revealed increased in-hospital mortality in Q6 and Q1 temperature groups, with fully adjusted odds ratios of 2.08 (95% confidence interval [CI]: 1.45-2.96) and 1.95 (95% CI: 1.35-2.79), respectively. Restricted cubic spline analysis demonstrated a U-shaped relationship between temperature on admission and mortality risk ( nonlinearity <0.001), with the nadir of risk observed at 36.8°C. The effect sizes and corresponding CIs below and above the threshold were 0.581 (95% CI: 0.434-0.777) and 1.674 (95% CI: 1.204-2.328), respectively. Stratified analyses further validated the robustness of this correlation. Our study establishes a nonlinear association between BT and in-hospital mortality in patients with both CHF and DM, with optimal suitable BT at 36.8°C. Further research is necessary to confirm this relationship.

摘要

体温(BT)已被用于评估各种疾病患者的预后。然而,充血性心力衰竭(CHF)和糖尿病(DM)患者在重症监护病房(ICU)中 BT 对死亡率的影响尚不清楚。我们使用来自医疗信息集市重症监护(MIMIC-IV)数据集的数据进行了回顾性队列研究。主要评估结果是住院死亡率。BT 在分析中被视为分类变量。使用多变量逻辑回归模型、限制立方样条和亚组分析来检查 ICU 入院时 BT 与住院死亡率之间的关联。该队列包括 7063 名同时患有 DM 和 CHF 的患者(3135 名女性和 3928 名男性),平均年龄为 71.5±12.2 岁。与参考组(Q4)相比,Q6 和 Q1 温度组的住院死亡率增加,完全调整后的优势比分别为 2.08(95%置信区间[CI]:1.45-2.96)和 1.95(95%CI:1.35-2.79)。限制立方样条分析表明,入院时体温与死亡率风险之间呈 U 型关系(非线性<0.001),风险最低点在 36.8°C 观察到。阈值以下和以上的效应大小和相应的置信区间分别为 0.581(95%CI:0.434-0.777)和 1.674(95%CI:1.204-2.328)。分层分析进一步验证了这种相关性的稳健性。我们的研究建立了 CHF 和 DM 患者 BT 与住院死亡率之间的非线性关联,最佳适宜 BT 为 36.8°C。需要进一步的研究来证实这种关系。

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引用本文的文献

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Association between Red Blood Cell Distribution Width and In-Hospital Mortality among Congestive Heart Failure Patients with Diabetes among Patients in the Intensive Care Unit: A Retrospective Cohort Study.重症监护病房中糖尿病性充血性心力衰竭患者红细胞分布宽度与院内死亡率的关联:一项回顾性队列研究
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