Chang Jie, Liu Liping, Han Zhiying
Department of Pediatrics, Shanxi Medical University, Taiyuan, 030000, China.
Department of Respiratory Medicine, Shanxi Provincial Children's Hospital (Shanxi Provincial Maternal and Child Health Hospital), Taiyuan, 030000, China.
Sci Rep. 2025 Mar 17;15(1):9141. doi: 10.1038/s41598-025-93862-0.
Body temperature (BT) monitoring is critical for the management of critically ill patients, and numerous studies have demonstrated that abnormal BT in ICU patients is linked to adverse outcomes. However, evidence regarding the association between admission BT and 28-day mortality in pediatric intensive care unit (PICU) patients is limited. This study aims to clarify the association between admission BT and 28-day mortality in critically ill pediatric patients. This retrospective analysis utilized the pediatric intensive care (PIC) database, comprising 7,350 patients. The primary outcome was 28-day mortality, while 90-day mortality and in-hospital mortality were assessed as secondary outcomes. Multivariate Cox regression analysis and smooth curve fitting were used to evaluate the relationship between BT and mortality. Ultimately, the 28-day mortality rate in the PICU was 3.5%. Severe hypothermia (HR 1.89, 95% CI 1.35-2.63) and severe hyperthermia (HR 1.97, 95% CI 1.28-3.05) were identified as independent risk factors for 28-day mortality. Curve fitting analysis indicated a U-shaped correlation between BT and 28-day mortality (inflection point = 37.2 °C). Therefore, we conclude that the severity of temperature abnormalities at admission, whether hypothermia or hyperthermia, is directly associated with an increased risk of mortality in pediatric patients.
体温（BT）监测对于危重症患者的管理至关重要，众多研究表明，重症监护病房（ICU）患者的体温异常与不良预后相关。然而，关于儿科重症监护病房（PICU）患者入院时体温与28天死亡率之间关联的证据有限。本研究旨在阐明危重症儿科患者入院时体温与28天死亡率之间的关联。这项回顾性分析利用了包含7350例患者的儿科重症监护（PIC）数据库。主要结局是28天死亡率，而90天死亡率和住院死亡率作为次要结局进行评估。采用多变量Cox回归分析和平滑曲线拟合来评估体温与死亡率之间的关系。最终，PICU的28天死亡率为3.5%。严重低温（HR 1.89，95%CI 1.35 - 2.63）和严重高温（HR 1.97，95%CI 1.28 - 3.05）被确定为28天死亡率的独立危险因素。曲线拟合分析表明体温与28天死亡率之间呈U形相关性（拐点 = 37.2°C）。因此，我们得出结论，入院时体温异常的严重程度，无论是低温还是高温，都与儿科患者死亡率增加直接相关。
