| 패혈성 쇼크 환자에서 응급의료센터에서 측정된 체온과 예후와의 연관성 |
최주환1
, 박유석1
, 정성필1, 신태건2, 김원영3, 최성혁4, 조유환5, 강구현6, 신종환7, 임태호8, 한갑수9, 서길준10, 대한쇼크연구회 |
1연세대학교 의과대학 응급의학교실
2성균관대학교 의과대학 삼성서울병원 응급의학과
3울산대학교 의과대학 서울아산병원 응급의학과
4고려대학교 의과대학 구로병원 응급의학과
5서울대학교 의과대학 분당서울대학교병원 응급의학과
6한림대학교 강남성심병원 응급의학과
7서울대학교 의과대학 보라매병원 응급의학과
8한양대학교 의과대학 응급의학교실
9고려대학교 의과대학 안암병원 응급의학과
10서울대학교 의과대학 응급의학교실 |
| Association between body temperature measured at the emergency department with prognosis in septic shock patients |
| Ju Hwan Choi1
, Yoo Seok Park1
, Sung Phil Chung1, Tae Gun Shin2, Won Young Kim3, Sung-Hyuk Choi4, You Hwan Jo5, Gu Hyun Kang6, Jonghwan Shin7, Tae Ho Lim8, Kap Su Han9, Gil Joon Suh10, Korean Shock Society (KoSS) Investigators |
1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
4Department of Emergency Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
5Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
6Department of Emergency Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
7Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
8Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea
9Department of Emergency Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
10Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea |
| Correspondence |
Yoo Seok Park ,Tel: 02-2228-2460, Fax: 02-2227-7908, Email: pys0905@yuhs.ac,
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Received: October 13, 2019; Revised: November 5, 2019 Accepted: November 6, 2019. Published online: August 31, 2020. |
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| ABSTRACT |
Objective:
Prior studies have explored the relationship between initial body temperature (BT) and mortality in patients with sepsis in the emergency department (ED). However, there has been no study on whether or not changes in BT are associated with prognosis in these patients. We hypothesize that BT measured upon ED arrival and septic shock registry enroll time are related to the prognosis of patients with septic shock.
Method:
We conducted a prospective, observational, registry-based study. Each patient was assigned to 1 of 4 groups according to BT upon ED arrival and registry enrollment. Odds ratios for 28-day mortality according to the patient group were estimated using multivariable logistic regression. We also conducted logistic regression sensitivity analysis, except for patients whose time interval between arrival and enrollment was less than 1 hour.
Results:
A total of 2,138 patients with septic shock were included. The 28-day mortalities were 13.7%, 11.2%, 13.0%, and 25.8% in groups 1, 2, 3, and 4, respectively (P<0.001). After adjusting for age, sex, mean atrial pressure, respiratory rate, Sequential Organ Failure Assessment score, lactate concentration, comorbidity, and suspicious infection focus, the risk of mortality was significantly low in patients from group 1 (adjusted odds ratio [aOR], 0.433; 95% confidence interval [CI], 0.310-0.604) and group 2 (aOR, 0.540; 95% CI, 0.336-0.868) compared with group 4. In the sensitivity analysis, group based on BT measured upon ED arrival and registry enrollment also remained an independent predictor of mortality.
Conclusion:
Afebrile status upon ED arrival and registry enrollment were strongly associated with higher 28-day mortality in patients with septic shock. |
| Key words:
Septic shock; Body temperature; Mortality; Emergency department |
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