重症患者体温与死亡率的关联:使用两个大型数据库进行的一项观察性研究
Daniel J Tan1, Jiayang Chen2, Yirui Zhou3
1Institute of Data Science, National University of Singapore, Singapore, Singapore.
European journal of medical research
|January 6, 2024
概括
在重症监护室 (ICU) 患者中保持37°C的体温 (BT) 与降低死亡率有关. 偏差低于36°C或高于38°C显著增加死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 生理学 生理学 生理学
- 健康 结果 研究 研究 结果
背景情况:
- 身体温度 (BT) 是一个关键的生理参数,在重症监护室 (ICU) 经常监测和管理.
- 虽然BT影响患者的结果,但在重症监护机构中,体温和死亡率之间的确切关系仍然不完全理解.
研究的目的:
- 在一大批ICU患者中调查体温与医院死亡率之间的关联.
- 为了确定与最低死亡风险相关的最佳体温范围.
主要方法:
- 一项使用MIMIC-IV和eICU数据库 (共计超过118,000名患者) 的回顾性队列研究.
- 用通用添加模型分析了前48小时的体温中位数与医院死亡率之间的关系.
- 分析对许多共同变量进行了调整,包括年龄,性别,严重程度得分 (APS-III,SOFA),并发症以及通风和血管压缩剂等干预措施.
主要成果:
- 在一般ICU患者群体和各种子组中确定了37°C的最佳体温.
- 在36-38°C范围内度过的时间增加与两组数据中医院死亡率显著降低有关.
- 相反,长时间的体温低于36°C或高于38°C独立地与死亡风险增加有关.
结论:
- 体温在37°C左右与ICU患者医院死亡风险最低相关.
- 这些发现支持进一步研究因果机制和潜在的临床指导方针,以积极的温度管理在重症监护.
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