Anaesthesia, critical care & pain medicine · 2026
The association between early core body temperature in ICU and mortality in spontaneous subarachnoid haemorrhage: a binational registry study.
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Shrestha Gentle Sunder, Premraj Lavienraj, Subramaniam Ashwin, Raith Eamon, Jeffcote Toby, James Cooper D, Udy Andrew, Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation
Аннотация
OBJECTIVE: Fever and hypothermia are important risk factors for mortality in critically ill patients. We examined the association between day-one (D1) core body temperature and in-hospital mortality in ICU patients with spontaneous subarachnoid haemorrhage (SAH).
METHODS: We performed a multicentre retrospective cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database. Adults (≥18 years) with SAH admitted to ICU between January 2018 and June 2024 were included (n = 7,567). Primary exposures were core temperature used for the Australian and New Zealand Risk of Death (ANZROD) score (TANZ), and the highest (THI) and lowest (TLO) core temperatures recorded during the first 24 ICU hours. The primary outcome was in-hospital mortality. Associations were modelled using generalised linear models with natural cubic splines and covariate adjustment.
RESULTS: Mean TANZ was 36.0 °C (SD 0.97), mean THI 37.3 °C (SD 0.68), and mean TLO 36.0 °C (SD 0.96). Overall in-hospital mortality was 17% (n = 1,304). TANZ, THI and TLO showed non-linear U-shaped associations with mortality. Lowest observed mortality occurred at TANZ 35.8-38.2 °C, THI 36.8-38.2 °C and TLO 36.1-37.8 °C. Mortality increased below these ranges for TANZ (OR:1.55, 95% CI:1.34-1.79), THI (OR:1.42, 95% CI:1.20-1.69) and TLO (OR:1.38, 95% CI:1.19-1.60), and above the optimal range of THI (OR: 1.47, 95% CI:1.19-1.80).
CONCLUSIONS: In critically ill SAH patients, D1 core temperature had a U-shaped association with in-hospital mortality. Further research should determine whether temperature variation is a modifiable risk factor in this population.
METHODS: We performed a multicentre retrospective cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database. Adults (≥18 years) with SAH admitted to ICU between January 2018 and June 2024 were included (n = 7,567). Primary exposures were core temperature used for the Australian and New Zealand Risk of Death (ANZROD) score (TANZ), and the highest (THI) and lowest (TLO) core temperatures recorded during the first 24 ICU hours. The primary outcome was in-hospital mortality. Associations were modelled using generalised linear models with natural cubic splines and covariate adjustment.
RESULTS: Mean TANZ was 36.0 °C (SD 0.97), mean THI 37.3 °C (SD 0.68), and mean TLO 36.0 °C (SD 0.96). Overall in-hospital mortality was 17% (n = 1,304). TANZ, THI and TLO showed non-linear U-shaped associations with mortality. Lowest observed mortality occurred at TANZ 35.8-38.2 °C, THI 36.8-38.2 °C and TLO 36.1-37.8 °C. Mortality increased below these ranges for TANZ (OR:1.55, 95% CI:1.34-1.79), THI (OR:1.42, 95% CI:1.20-1.69) and TLO (OR:1.38, 95% CI:1.19-1.60), and above the optimal range of THI (OR: 1.47, 95% CI:1.19-1.80).
CONCLUSIONS: In critically ill SAH patients, D1 core temperature had a U-shaped association with in-hospital mortality. Further research should determine whether temperature variation is a modifiable risk factor in this population.