重症监护病房合并糖尿病的充血性心力衰竭患者体温与住院死亡率的关系:一项回顾性队列研究。

IF 0.8 4区 医学 Q4 CRITICAL CARE MEDICINE
Kai Zhang, Yu Han, Fangming Gu, Zhaoxuan Gu, JiaYing Liang, JiaYu Zhao, Jianguo Chen, Bowen Chen, Min Gao, Zhengyan Hou, Xiaoqi Yu, Tianyi Cai, Yafang Gao, Rui Hu, Jinyu Xie, Tianzhou Liu, Bo Li
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引用次数: 0

摘要

体温(BT)已被用于评估各种疾病患者的预后。然而,BT对充血性心力衰竭(CHF)和糖尿病(DM)患者重症监护病房(ICU)死亡率的影响尚不清楚。我们使用重症监护医疗信息市场(MIMIC)-IV数据集的数据进行了回顾性队列研究。评估的主要结局是住院死亡率。BT在分析中被视为分类变量。采用多变量logistic回归模型、受限三次样条和亚组分析,检验了BT与ICU入院和住院死亡率之间的关系。该队列包括7063例DM和CHF患者(女性3135例,男性3928例),平均年龄71.5±12.2岁。对照组(Q4)的比较分析显示,Q6和Q1温度组的住院死亡率增加,完全调整后的优势比分别为2.08(95%置信区间[CI]: 1.45-2.96)和1.95 (95% CI: 1.35-2.79)。限制三次样条分析显示入院温度与死亡风险呈u型关系(p非线性)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association Between Body Temperature and In-Hospital Mortality Among Congestive Heart Failure Patients with Diabetes in Intensive Care Unit: A Retrospective Cohort Study.

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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来源期刊
CiteScore
2.50
自引率
8.30%
发文量
35
期刊介绍: Therapeutic Hypothermia and Temperature Management is the first and only journal to cover all aspects of hypothermia and temperature considerations relevant to this exciting field, including its application in cardiac arrest, spinal cord and traumatic brain injury, stroke, burns, and much more. The Journal provides a strong multidisciplinary forum to ensure that research advances are well disseminated, and that therapeutic hypothermia is well understood and used effectively to enhance patient outcomes. Novel findings from translational preclinical investigations as well as clinical studies and trials are featured in original articles, state-of-the-art review articles, protocols and best practices. Therapeutic Hypothermia and Temperature Management coverage includes: Temperature mechanisms and cooling strategies Protocols, risk factors, and drug interventions Intraoperative considerations Post-resuscitation cooling ICU management.
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