Clinical characteristics associated with septic shock complicating hypothermia: a retrospective cohort study from the MIMIC-IV database.

Background: Septic shock, a severe consequence of sepsis, has a high mortality rate. Hypothermia can aggravate the state of septic shock patients, which influences therapeutic response and overall prognosis. Nevertheless, the precise mechanism of action associated with septic shock in hypothermia remains unclear. This study aimed to investigate clinical factors and develop a predictive model for accurately assessing the risk probability of concomitant hypothermia in septic shock patients.

Methods: This study utilized the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, which collected data on patients with septic shock from 2008 to 2019. Several covariates were introduced to identify clinical factors related to septic shock patients complicated by hypothermia. The univariate Logistic regression analysis, machine learning, and multivariate Logistic regression analysis identified covariates as significant independent predictors for patients with septic shock complicating hypothermia. Afterwards, a nomogram was constructed on the basis of the identified independent predictors, with predictive performance evaluated via the receiver operating characteristic (ROC) curve.

Results: A total of 1640 participants with septic shock (hypothermia:non-hypothermia = 134:1506) were screened after the exclusion of samples. A notable disparity was observed in several covariates between septic shock patients presenting with concomitant hypothermia and those without hypothermia, such as hemoglobin, bicarbonate, and heart rate. Subsequent analyses revealed that hemoglobin, heart rate, respiratory rate, lactate, and dopamine were associated with prognosis in septic shock complicating hypothermia. Moreover, the constructed nomogram displayed promising potential for effectively evaluating septic shock complicated by hypothermia, which exhibited an area under the curve (AUC) of 0.787.

Conclusions: Five clinical factors-hemoglobin, heart rate, respiratory rate, lactate, and dopamine-that were significantly associated with hypothermia in septic shock, suggesting that these factors could serve as potential predictors and provide a reference for clinical risk assessment.