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Acute and Critical Care > Accepted Articles
doi: https://doi.org/10.4266/acc.2018.00255    [Accepted]
Published online January 9, 2019.
Association of Immediate Postoperative Temperature in the Surgical Intensive Care Unit with 1-Year Mortality: Retrospective Analysis Using Digital Axillary Thermometers
Jiwook Kim1, Tak Kyu Oh2 , Jaebong Lee3, Saeyeon Kim2, In-Ae Song2
1Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea
2Department of Anesthesiology and Pain Medicine and 3Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence  In-Ae Song ,Tel: +82-31-787-7499, Fax: +82-31-787-4063, Email: songoficu@outlook.kr
Received: August 10, 2018; Revised: November 8, 2018   Accepted: November 27, 2018.  Published online: January 9, 2019.
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.
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. Multivariate logistic regression analysis with restricted cubic splines was used to evaluate the association between temperature and outcomes.
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 (36.6ºC) was associated with increases in 1-year mortality (≤36.6ºC: linear coefficient, –0.531; P<0.001 and ≥36.6ºC: 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.
An increase or decrease in body temperature (vs. 36.6ºC) 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.
Key Words: critical care; intensive care units; temperature
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