Triage body temperature predicts outcome in cats at emergency department admission: a retrospective study of 1440 cases (January 2018 to December 2021).
Alessandra Pontiero, Cecilia Bulgarelli, Elena Ciuffoli, Francesca Buzzurra, Agnese Villani, Roberta Troìa, Massimo Giunti
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引用次数: 0
Abstract
Objectives: The aim of the study was to evaluate the association between triage body temperature (BT) and outcome in cats presenting to the emergency department (ED).
Methods: A retrospective observational study was conducted on cats presented to the ED. BT, clinical diagnosis and outcome were recorded. BT was categorised as follows: normothermia (37.8-39.7°C); hyperthermia (⩾39.8°C); mild hypothermia (36.8-37.7°C); moderate hypothermia (35.6-36.7°C); severe hypothermia (33.1-35.5°C); and critical hypothermia (⩽33°C). Outcome in the ED was categorised as death, euthanasia, hospital admission and discharge. Outcome at hospital discharge was evaluated in patients admitted to the intensive care unit (ICU). Systemic inflammatory response syndrome (SIRS) was identified in patients. No-SIRS cats were divided into three disease categories (urinary system, cardiovascular and miscellanea) and SIRS cats into four categories (urinary system, cardiovascular, trauma and miscellanea). The presence of sepsis was evaluated. Non-parametric statistics were used.
Results: A total of 1440 cats were included. The hospital mortality rate was 21.9%. Hypothermia in the ED was reported in 510 (35.4%) cats, normothermia in 849 (59%) cats and hyperthermia in 81 (5.6%) cats. In the ED, the median temperature in non-survivors (35.4°C, 95% confidence interval [CI] 34.6-36.3) was significantly lower than in survivors (38.2°C, 95% CI 38.1-38.3; P <0.0001). The risk of non-survival in the ED was significantly higher in cats with a decreased BT, progressively increasing with the severity of hypothermia (P <0.0001). Furthermore, BT was significantly associated with a higher risk of mortality in the ICU (P <0.0001). A diagnosis of sepsis was associated with a high prevalence of hypothermia (79/124 cats, 63.7%) and a higher risk of non-survival (odds ratio [OR] 2.62, 95% CI 1.52-4.54; P = 0.0006). The mortality risk significantly increased in SIRS cats with a cardiovascular disease (OR 8.27, 95% CI 4.09-16.68; P <0.0001).
Conclusions and relevance: Hypothermia is common in cats at ED admission and is significantly associated with outcome. Triage hypothermia might identify patients with sepsis or SIRS complicated by comorbidities, such as cardiovascular and urinary diseases.
目的:本研究的目的是评估在急诊科(ED)就诊的猫的分诊体温(BT)与预后之间的关系。方法:对就诊猫进行回顾性观察研究,记录BT、临床诊断及预后。BT分类如下:常温(37.8-39.7°C);高热(⩾39.8°C);轻度低温(36.8-37.7°C);中低温(35.6-36.7°C);重度低温(33.1-35.5°C);和临界低温(≥33°C)。急诊科的结局分为死亡、安乐死、住院和出院。出院时的结果被评估患者入院的重症监护病房(ICU)。全身性炎症反应综合征(SIRS)。将未患SIRS的猫分为泌尿系统、心血管和杂项3类,将患有SIRS的猫分为泌尿系统、心血管、创伤和杂项4类。评估脓毒症的存在。采用非参数统计。结果:共纳入1440只猫。住院死亡率为21.9%。有510只(35.4%)猫在急诊发生过体温过低,849只(59%)猫发生过体温过低,81只(5.6%)猫发生过体温过高。在ED中,非幸存者的中位温度(35.4°C, 95%可信区间[CI] 34.6-36.3)显著低于幸存者(38.2°C, 95% CI 38.1-38.3;P P P P = 0.0006)。伴有心血管疾病的SIRS猫的死亡风险显著增加(OR 8.27, 95% CI 4.09-16.68;结论和相关性:猫在急诊入院时体温过低很常见,并与预后显著相关。分诊低温可以识别脓毒症或SIRS合并合并症的患者,如心血管和泌尿系统疾病。
期刊介绍:
JFMS is an international, peer-reviewed journal aimed at both practitioners and researchers with an interest in the clinical veterinary healthcare of domestic cats. The journal is published monthly in two formats: ‘Classic’ editions containing high-quality original papers on all aspects of feline medicine and surgery, including basic research relevant to clinical practice; and dedicated ‘Clinical Practice’ editions primarily containing opinionated review articles providing state-of-the-art information for feline clinicians, along with other relevant articles such as consensus guidelines.