Acute Crit Care.  2019 Feb;34(1):53-59. 10.4266/acc.2019.00255.

Association of Immediate Postoperative Temperature in the Surgical Intensive Care Unit with 1-Year Mortality: Retrospective Analysis Using Digital Axillary Thermometers

• Kim J
• Oh TK
• Lee J
• Kim S
• Song IA

• KMID: 2449380
• DOI: http://doi.org/10.4266/acc.2019.00255

Abstract

BACKGROUND
Postoperative body temperature is closely associated with prognosis although there is limited research regarding this association at postoperative intensive care unit (ICU) admission. Furthermore, no studies have used digital axillary thermometers to measure postoperative body temperature. This study investigated the association between mortality and postoperative temperature measured using a digital axillary thermometer within 10 minutes after ICU admission.
METHODS
This retrospective observational study evaluated data from adult patients admitted to an ICU after elective or emergency surgery. The primary outcome was 1-year mortality after ICU admission. Multivariable logistic regression analysis with restricted cubic splines was used to evaluate the association between temperature and outcomes.
RESULTS
We evaluated data from 5,868 patients admitted between January 1, 2013 and May 31, 2016, including 5,311 patients (90.5%) who underwent noncardiovascular surgery and 557 patients (9.5%) who underwent cardiovascular surgery. Deviation from the median temperature (36.6℃) was associated with increases in 1-year mortality (≤ 36.6℃: linear coefficient, −0.531; P < 0.001 and ≥36.6℃: spline coefficient, 0.756; P < 0.001). Similar statistically significant results were observed in the noncardiovascular surgery group, but not in the cardiovascular surgery group.
CONCLUSIONS
An increase or decrease in body temperature (vs. 36.6℃) measured using digital axillary thermometers within 10 minutes of postoperative ICU admission was associated with increased 1-year mortality. However, no significant association was observed after cardiovascular surgery. These results suggest that postoperative temperature is associated with long-term mortality in patients admitted to the surgical ICU in the postoperative period.

Keyword

critical care; intensive care units; temperature

MeSH Terms

Adult
Body Temperature
Critical Care*
Emergencies
Humans
Intensive Care Units
Logistic Models
Mortality*
Observational Study
Postoperative Period
Prognosis
Retrospective Studies*
Thermometers*

Figure

• 

  Figure 1. Restricted cubic splines between initial postoperative axillary temperature in the intensive care unit (ICU) and postoperative 1-year mortality. The results are shown for (A) noncardiovascular surgery and (B) cardiovascular surgery. Body temperature was defined as the first temperature measured using a digital axillary thermometer within 10 minutes of entry into the ICU. a The median value of the distribution of first postoperative body temperature in the ICU.

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