Abstract Objective To evaluate whether admission body temperature (BT) is associated with in-hospital mortality in critically ill children with pneumonia. Design Retrospective cohort study. Methods This study employed a retrospective cohort design using records derived from the Pediatric Intensive Care (PIC) database collected between 2010 and 2018. Children aged > 28 days and < 18 years who were admitted to the PICU with a diagnosis of pneumonia were included in the analysis. Based on BT measured at admission, patients were grouped as hypothermic (< 36.5℃), normothermic (36.5–37.4℃), or hyperthermic (≥ 37.5℃), with additional classification according to the degree of hyperthermia. The association between admission BT and in-hospital mortality was evaluated using multivariable logistic regression. Furthermore, restricted cubic spline modeling, along with subgroup and sensitivity analyses, was undertaken to test the consistency of the findings. Results In total, 394 pediatric patients with severe pneumonia were retained for analysis. Admission BT was independently linked to in-hospital mortality, with higher values corresponding to an increased risk of death. When compared with patients presenting with normal BT, those with hyperthermia exhibited a substantially greater likelihood of mortality (OR 3.10, 95% CI 1.26–7.62), and this risk was even more pronounced among individuals with severe hyperthermia (OR 5.74, 95% CI 1.55–21.20). Hypothermia, however, showed no statistically significant association with mortality. Analysis using restricted cubic splines supported a linear pattern between BT and mortality risk. Subgroup analyses revealed no significant effect modification by age, gender, or SpO2. Conclusions Among critically ill children with pneumonia, elevated admission BT—particularly severe hyperthermia—was associated with increased in-hospital mortality. Admission BT may be a readily accessible and clinically informative parameter for early risk stratification in the PICU. Clinical trial number Not applicable.
Zhang et al. (Fri,) studied this question.