Key result
ICU admission temperature linked to U-shaped mortality risk in CHF and diabetes, lowest at 36.8°C.
Why the study?
The impact of body temperature on ICU mortality among patients with congestive heart failure and diabetes mellitus remains unclear.
Does body temperature on ICU admission affect in-hospital mortality in patients with congestive heart failure and diabetes?
Cohort (n=7,063)
Does body temperature on ICU admission affect in-hospital mortality in patients with congestive heart failure and diabetes?
Effect estimate: OR 2.08 (Q6 vs Q4) and OR 1.95 (Q1 vs Q4) (95% CI 1.45-2.96 and 1.35-2.79)
p-value: p=<0.001
In ICU patients with concurrent heart failure and diabetes, body temperature on admission exhibits a U-shaped association with in-hospital mortality, with the lowest risk observed at 36.8°C.
Admission temperature should not guide management in CHF-diabetes ICU patients; leaves open whether normothermia targets warrant prospective trials.
Body temperature (BT) has been utilized to assess patient outcomes across various diseases. However, the impact of BT on mortality in the intensive care unit (ICU) among patients with congestive heart failure (CHF) and diabetes mellitus (DM) remains unclear. We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care (MIMIC)-IV data set. The primary outcome assessed was in-hospital mortality rates. BT was treated as a categorical variable in the analyses. The association between BT on ICU admission and in-hospital mortality was examined using multivariable logistic regression models, restricted cubic spline, and subgroup analysis. The cohort comprised 7063 patients with both DM and CHF (3135 females and 3928 males), with an average age of 71.5 ± 12.2 years. Comparative analysis of the reference group (Q4) revealed increased in-hospital mortality in Q6 and Q1 temperature groups, with fully adjusted odds ratios of 2.08 (95% confidence interval [CI]: 1.45–2.96) and 1.95 (95% CI: 1.35–2.79), respectively. Restricted cubic spline analysis demonstrated a U-shaped relationship between temperature on admission and mortality risk ( p nonlinearity <0.001), with the nadir of risk observed at 36.8°C. The effect sizes and corresponding CIs below and above the threshold were 0.581 (95% CI: 0.434–0.777) and 1.674 (95% CI: 1.204–2.328), respectively. Stratified analyses further validated the robustness of this correlation. Our study establishes a nonlinear association between BT and in-hospital mortality in patients with both CHF and DM, with optimal suitable BT at 36.8°C. Further research is necessary to confirm this relationship.
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Zhang et al. (2023) conducted a cohort in Congestive heart failure and diabetes mellitus (n=7,063). Body temperature on ICU admission vs. Reference group (Q4) / 36.8°C was evaluated on In-hospital mortality (OR 2.08 (Q6 vs Q4) and OR 1.95 (Q1 vs Q4), 95% CI 1.45-2.96 and 1.35-2.79, p=<0.001). Body temperature on ICU admission exhibited a U-shaped association with in-hospital mortality in patients with CHF and diabetes, with the lowest risk at 36.8°C (p nonlinearity <0.001).
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