The optimal oral body temperature cutoff and other factors predictive of sepsis diagnosis in elderly patients.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Medicine Pub Date : 2022-07-01 Epub Date: 2022-07-09 DOI:10.4103/atm.atm_52_22

Majid Alsalamah, Bashaer Alrehaili, Amal Almoamary, Abdulrahman Al-Juad, Mutasim Badri, Ashraf El-Metwally

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引用次数: 1

Abstract

Introduction: The aim of this study was to identify the optimal oral temperature cut-off value and other factors predictive of sepsis in elderly patients presenting to emergency department.

Methods: A hospital-based retrospective study was performed on all elderly patients who presented to the Adult Emergency Department at King Abdulaziz Medical City in Riyadh (January to December 31, 2018).

Results: Of total of 13,856 patients, 2170 (15.7%) were diagnosed with sepsis. The associated area under the curve estimate was 0.73, 95% confidence interval (CI) 0.72-0.74. Body temperature ≥37.3 was found as optimal cut-point with sensitivity = 50.97% and specificity = 87.22% and 82.39% of patients with sepsis will be correctly classified using this cut-off. An increase of 1° in body temperature was associated with an odds ratio of 9.95 (95% CI 8.95-11.06, P < 0.0001). Those aged ≥100 years having 11.12 (95% CI 2.29-20.88, P < 0.0001) times the likelihood for sepsis diagnosis compared with those aged 60-69 years. People admitted in weather such as winter, spring, or autumn were more likely to develop sepsis than people admitted in summer.

Conclusion: The risk factors of sepsis such as age, temperature, and seasonal variation inform important evidence-based decisions. The hospitals dealing with sepsis patients should assess older patients for other severe illnesses or co-morbid that might lead to sepsis if left untreated. Therefore, older patients need to be prioritized over younger patients. The body temperature of patients admitted to hospitals needs to be monitored critically and it is important to consider seasonal fluctuations while managing cases of sepsis and allocating resources. Our findings suggest that clinicians should explore the possibility of sepsis in elderly patients admitted to emergency units with oral temperature ≥37.3°C. Risk factors for sepsis reported in this study could inform evidence-based decisions.

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老年患者最佳口腔体温临界值及其他预测败血症诊断的因素。

前言:本研究的目的是确定急诊老年患者脓毒症的最佳口腔温度临界值及其他预测因素。方法:对2018年1月至12月31日在利雅得阿卜杜勒阿齐兹国王医疗城成人急诊科就诊的所有老年患者进行以医院为基础的回顾性研究。结果:13856例患者中，2170例(15.7%)诊断为败血症。曲线估计下的相关面积为0.73,95%置信区间(CI)为0.72-0.74。以体温≥37.3为最佳分界点，灵敏度为50.97%，特异性为87.22%，82.39%的脓毒症患者可根据该分界点正确分类。体温升高1°与比值比为9.95相关(95% CI 8.95-11.06, P < 0.0001)。年龄≥100岁的患者与60-69岁的患者相比，败血症诊断的可能性为11.12倍(95% CI 2.29-20.88, P < 0.0001)。在冬季、春季或秋季入院的患者比在夏季入院的患者更容易患败血症。结论:脓毒症的危险因素如年龄、温度和季节变化是重要的循证决策。处理败血症患者的医院应评估老年患者是否患有其他严重疾病或合并症，如果不及时治疗可能导致败血症。因此，老年患者需要优先于年轻患者。入院患者的体温需要严格监测，在管理败血症病例和分配资源时考虑季节性波动很重要。我们的研究结果提示，临床医生应探讨口腔温度≥37.3°C的急诊老年患者发生脓毒症的可能性。本研究报告的脓毒症危险因素可以为基于证据的决策提供信息。

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来源期刊

Annals of Thoracic Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-RESPIRATORY SYSTEM

CiteScore

4.10

自引率

4.30%

发文量

审稿时长

>12 weeks

期刊介绍： The journal will cover studies related to multidisciplinary specialties of chest medicine, such as adult and pediatrics pulmonology, thoracic surgery, critical care medicine, respiratory care, transplantation, sleep medicine, related basic medical sciences, and more. The journal also features basic science, special reports, case reports, board review , and more. Editorials and communications to the editor that explore controversial issues and encourage further discussion by physicians dealing with chest medicine.