Temperature Trajectories Correlate With Cardiac Function in Patients With Sepsis

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Body temperature patterns in infected patients reflect dynamic clinical and immune responses.
• Understanding these temperature trajectories is crucial for predicting patient outcomes.

Purpose of the Study:

• To investigate the association between distinct body temperature trajectory subphenotypes and cardiac dysfunction.
• To determine if temperature patterns can predict echocardiographic evidence of cardiac dysfunction in sepsis.

Main Methods:

• A retrospective cohort study was conducted across four hospitals within an academic healthcare system.
• Adult patients with suspected infections undergoing echocardiography within 48 hours of admission were included.
• Patients were classified into four temperature trajectory subphenotypes using a validated model.

Main Results:

• Among 1,923 septic patients, four subphenotypes were identified: hyperthermic (slow/fast resolvers), normothermic, and hypothermic.
• Hypothermic patients demonstrated the highest rates of left ventricular dysfunction (46%) and right ventricular dysfunction (39%).
• Multivariable analysis revealed hypothermic patients had a significantly higher odds ratio (2.65) for reduced left ventricular ejection fraction, increased vasopressor/inotrope use, and higher in-hospital mortality.

Conclusions:

• Temperature trajectories in sepsis are significantly linked to cardiac dysfunction, particularly in hypothermic patients.
• Hypothermia in sepsis is associated with the highest odds of both left and right ventricular dysfunction.
• Bedside temperature monitoring may serve as an early indicator for echocardiographic assessment in sepsis, warranting further validation.