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传染病患者体温过低严重程度与院内死亡率之间的关联:J点登记研究。

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

作者信息

Shiozumi Tadaharu, Miyamoto Yuki, Morita Sachiko, Ehara Naoki, Miyamae Nobuhiro, Okada Yohei, Jo Takaaki, Sumida Yasuyuki, Okada Nobunaga, Watanabe Makoto, Nozawa Masahiro, Tsuruoka Ayumu, Fujimoto Yoshihiro, Okumura Yoshiki, Kitamura Tetsuhisa, Matsuyama Tasuku

机构信息

Department of Emergency Medicine Kyoto Prefectural University of Medicine Kyoto Japan.

Department of Emergency and Critical Care Medicine Senri Critical Care Medical Center, Saiseikai Senri Hospital Suita Japan.

出版信息

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

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.

摘要

目的

体温过低与脓毒症患者的不良预后相关。然而,尚无研究探讨体温过低的严重程度与预后之间的相关性。

方法

利用日本意外低温网络登记处(J-Point登记处)的数据,我们对2011年4月1日至2016年3月31日期间12个中心的18岁及以上初始体温≤35°C的成年传染病患者进行了研究。根据体温将患者分为三组:第一三分位数组(T1)(32.0 - 35.0°C)、第二三分位数组(T2)(28.0 - 31.9°C)和第三三分位数组(T3)(<28.0°C)。以院内死亡率作为评估预后的指标。我们进行了多变量逻辑回归分析,以研究这三个类别与院内死亡发生之间的关系。

结果

共登记了572例患者,确定了170例符合条件的患者。其中,55例在T1组(32.0 - 35.0°C),76例在T2组(28.0 - 31.9°C),39例在T3组(<28.0°C)。患有传染病的意外低温(AH)患者的总体院内死亡率为34.1%。T1、T2和T3组的院内死亡率分别为34.5%、36.8%和28.2%。多变量分析显示,三组之间在院内死亡率方面无显著差异(T2与T1相比,调整后的比值比[OR]:1.29;95%置信区间[CI]:0.58 - 2.89;T3与T1相比,调整后的OR:0.83;95% CI:0.30 - 2.31)。

结论

在这项多中心回顾性观察研究中,体温过低的严重程度与患有传染病的AH患者的院内死亡率无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/521e/11096693/9a96bdbb141a/AMS2-11-e964-g003.jpg

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