Related Experiment Videos
The association between early core body temperature in ICU and mortality in spontaneous subarachnoid haemorrhage: a
Gentle Sunder Shrestha1, Lavienraj Premraj2, Ashwin Subramaniam3
1Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Critical Care Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
Objective:
Fever and hypothermia are important risk factors for mortality in critically ill patients. We examined the association between day-one (D1) core body temperature and in-hospital mortality in ICU patients with spontaneous subarachnoid haemorrhage (SAH).
Methods:
We performed a multicentre retrospective cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database. Adults (≥18 years) with SAH admitted to ICU between January 2018 and June 2024 were included (n = 7,567). Primary exposures were core temperature used for the Australian and New Zealand Risk of Death (ANZROD) score (TANZ), and the highest (THI) and lowest (TLO) core temperatures recorded during the first 24 ICU hours. The primary outcome was in-hospital mortality. Associations were modelled using generalised linear models with natural cubic splines and covariate adjustment.
Results:
Mean TANZ was 36.0 °C (SD 0.97), mean THI 37.3 °C (SD 0.68), and mean TLO 36.0 °C (SD 0.96). Overall in-hospital mortality was 17% (n = 1,304). TANZ, THI and TLO showed non-linear U-shaped associations with mortality. Lowest observed mortality occurred at TANZ 35.8-38.2 °C, THI 36.8-38.2 °C and TLO 36.1-37.8 °C. Mortality increased below these ranges for TANZ (OR:1.55, 95% CI:1.34-1.79), THI (OR:1.42, 95% CI:1.20-1.69) and TLO (OR:1.38, 95% CI:1.19-1.60), and above the optimal range of THI (OR: 1.47, 95% CI:1.19-1.80).
Conclusions:
In critically ill SAH patients, D1 core temperature had a U-shaped association with in-hospital mortality. Further research should determine whether temperature variation is a modifiable risk factor in this population.
Related Concept Videos
01:19Assessing Body Temperature - Temporal Artery
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
01:29Decreased Body Temperature
01:28Factors Affecting Body Temperature
Factors may include:
01:14Assessing Body Temperature - Axilla
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...