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Hypothermia or hyperthermia, which is associated with patient outcomes in critically ill children with sepsis? -A

Huabin Wang1,2,3, Yanhua Chang1, Meiyun Xin1,4

  • 1Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China.

BMJ Open
|April 17, 2023
PubMed

Insights

In pediatric sepsis, abnormal body temperatures within 24 hours are linked to higher in-hospital mortality. Both hypothermia and hyperthermia significantly increase the risk of death in critically ill children.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Clinical epidemiology

Background:

  • Early identification of high-risk pediatric sepsis patients is crucial for timely treatment and improved outcomes.
  • Body temperature is a key vital sign in assessing sepsis severity.

Purpose of the Study:

  • To evaluate the association between average body temperature within 24 hours of admission and the short-term prognosis of pediatric sepsis patients.
  • To identify temperature thresholds indicative of poor prognosis in pediatric sepsis.

Main Methods:

  • Retrospective cohort study including 1144 pediatric sepsis patients.
  • Analysis of in-hospital mortality and length of hospital stay as primary and secondary outcomes.
  • Utilized LOWESS and multivariate logistic regression to assess temperature-mortality relationships.

Main Results:

  • A 'U'-shaped relationship was observed between initial body temperature and in-hospital mortality.
  • Severe hypothermia (OR 14.72), mild hypothermia (OR 3.71), mild hyperthermia (OR 3.41), and severe hyperthermia (OR 5.15) were independent risk factors for mortality.
  • Initial body temperature was a significant predictor of in-hospital death.

Conclusions:

  • Both hypothermic and hyperthermic states in pediatric sepsis patients are associated with increased in-hospital mortality.
  • The degree of temperature abnormality on the first day is directly correlated with the risk of death.
Abstract

Keywords:
PAEDIATRICSPaediatric infectious disease & immunisationPaediatric intensive & critical care

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