Does Initial Temperature in the Emergency Department Predict Outcomes in Patients Admitted for Sepsis?

Publication date: Available online 21 July 2018

Source: The Journal of Emergency Medicine

Author(s): Boris Khodorkovsky, Elias Youssef, Frosso Adamakos, Tiffany Cina, Amanda Falco, Lauren LaMura, Anthony Marion, Samuel Nathan, Barry Hahn

Abstract

Background

Sepsis is a leading cause of morbidity and mortality in hospitalized patients. Prompt recognition and early treatment has been shown to improve mortality. Both low and high temperature are among the four elements of systemic inflammatory response required for the diagnosis of sepsis. We hypothesized that initial temperature has an effect on the identification, treatment, and outcomes of septic patients.

Objective

Our aim was to determine the prognostic and diagnostic utility of the initial recorded body temperature in patients presenting to the emergency department (ED) with sepsis.

Methods

This retrospective cohort study was conducted in the ED of a single facility during the study period of January 1, 2014 through December 31, 2014. Inclusion criteria were adult subjects 18 years of age and older who were admitted to the hospital from the ED with a diagnosis of sepsis.

Results

Hypothermia on presentation was associated with a longer time to antibiotics treatment of 338.6 min (p = 0.002), longer length of stay of 14.5 days (p < 0.001), higher rate of intensive care unit (ICU) admission of 32.7% (p = 0.003), and higher mortality rate of 30.8% (p < 0.001).

Conclusions

In this study of adult patients diagnosed in the ED with sepsis, hypothermia correlated with increased time to initial antibiotics, length of stay, rate of ICU admission, and mortality. Therefore, hypothermia in the setting of sepsis requires early and aggressive intervention to prevent adverse outcomes and delays in care.

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