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Erschienen in: European Journal of Trauma and Emergency Surgery 1/2022

14.09.2020 | Original Article

Body temperature and in-hospital mortality in trauma patients: analysis of a nationwide trauma database in Japan

verfasst von: Asami Okada, Yohei Okada, Hiromichi Narumiya, Wataru Ishii, Tetsuhisa Kitamura, Ryoji Iiduka

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2022

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Abstract

Purpose

Avoiding body temperature (BT) abnormalities has been emphasized in trauma care, and BT correction in the initial treatment period may improve patient outcome. However, the effect of hyperthermia at hospital arrival on mortality in trauma patients is unclear. This study aimed to identify the association between BT and in-hospital mortality among adult trauma patients.

Methods

This was a retrospective analysis of a multi-centre prospective cohort study. Data were obtained from the Japan Trauma Data Bank (JTDB). Adult trauma patients who were transferred directly from the scene of injury to the hospital and registered in the JTDB between January 2004 and December 2017 were included. The primary outcome was the association between BT at hospital arrival and in-hospital mortality. BT at hospital arrival was classified by 1 °C strata. We conducted multivariable logistic regression analyses to calculate the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for in-hospital mortality for each BT group using 36.0–36.9 °C as a reference.

Results

Overall, 153,117 patients were included. The total mortality rate was 7% (n = 10,118). The adjusted OR for in-hospital mortality for < 35.0 °C was 1.65 (95% CI 1.51–1.79, p < 0.001), 35.0–35.9 °C was 1.33 (95% CI 1.25–1.41, p < 0.001), 37.0–37.9 °C was 0.99 (95% CI 0.91–1.07, p = 0.639), 38.0–38.9 °C was 1.30 (95% CI 1.08–1.56, p = 0.007) and > 39.0 °C was 1.62 (95% CI 1.18–2.22, p = 0.003) compared to that for normothermia.

Conclusions

Our results reveal that hypothermia and hyperthermia at hospital arrival are associated with increased in-hospital mortality in adult trauma patients.
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Literatur
1.
Zurück zum Zitat Surgeons Aco. Advanced Trauma Life Support (ATLS®) 9th ed. Surgeons Aco. Advanced Trauma Life Support (ATLS®) 9th ed.
2.
Zurück zum Zitat Jurkovich GJ, Greiser WB, Luterman A, Curreri PW. Hypothermia in trauma victims: an ominous predictor of survival. J Trauma. 1987;27:1019–24.CrossRef Jurkovich GJ, Greiser WB, Luterman A, Curreri PW. Hypothermia in trauma victims: an ominous predictor of survival. J Trauma. 1987;27:1019–24.CrossRef
3.
Zurück zum Zitat Trentzsch H, Huber-Wagner S, Hildebrand F, Kanz KG, Faist E, Piltz S, et al. Hypothermia for prediction of death in severely injured blunt trauma patients. Shock. 2012;37:131–9.CrossRef Trentzsch H, Huber-Wagner S, Hildebrand F, Kanz KG, Faist E, Piltz S, et al. Hypothermia for prediction of death in severely injured blunt trauma patients. Shock. 2012;37:131–9.CrossRef
4.
Zurück zum Zitat Lapostolle F, Sebbah JL, Couvreur J, Koch FX, Savary D, Tazarourte K, et al. Risk factors for onset of hypothermia in trauma victims: the HypoTraum study. Crit Care. 2012;16:R142.CrossRef Lapostolle F, Sebbah JL, Couvreur J, Koch FX, Savary D, Tazarourte K, et al. Risk factors for onset of hypothermia in trauma victims: the HypoTraum study. Crit Care. 2012;16:R142.CrossRef
5.
Zurück zum Zitat Hinson HE, Rowell S, Morris C, Lin AL, Schreiber MA. Early fever after trauma: does it matter? J Trauma Acute Care Surg. 2018;84:19–24.CrossRef Hinson HE, Rowell S, Morris C, Lin AL, Schreiber MA. Early fever after trauma: does it matter? J Trauma Acute Care Surg. 2018;84:19–24.CrossRef
6.
Zurück zum Zitat Li J, Jiang JY. Chinese Head Trauma Data Bank: effect of hyperthermia on the outcome of acute head trauma patients. J Neurotrauma. 2012;29:96–100.CrossRef Li J, Jiang JY. Chinese Head Trauma Data Bank: effect of hyperthermia on the outcome of acute head trauma patients. J Neurotrauma. 2012;29:96–100.CrossRef
7.
Zurück zum Zitat von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7.CrossRef von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7.CrossRef
8.
Zurück zum Zitat Hondo K, Shiraishi A, Fujie S, Saitoh D, Otomo Y. In-hospital trauma mortality has decreased in Japan possibly due to trauma education. J Am Coll Surg. 2013;217:850–7.CrossRef Hondo K, Shiraishi A, Fujie S, Saitoh D, Otomo Y. In-hospital trauma mortality has decreased in Japan possibly due to trauma education. J Am Coll Surg. 2013;217:850–7.CrossRef
10.
Zurück zum Zitat Endo A, Shiraishi A, Matsui H, Hondo K, Otomo Y. Assessment of progress in early trauma care in Japan over the past decade: achievements and areas for future improvement. J Am Coll Surg. 2017;224:191–8.CrossRef Endo A, Shiraishi A, Matsui H, Hondo K, Otomo Y. Assessment of progress in early trauma care in Japan over the past decade: achievements and areas for future improvement. J Am Coll Surg. 2017;224:191–8.CrossRef
12.
Zurück zum Zitat Lecky F, Woodford M, Edwards A, Bouamra O, Coats T. Trauma scoring systems and databases. Br J Anaesth. 2014;113:286–94.CrossRef Lecky F, Woodford M, Edwards A, Bouamra O, Coats T. Trauma scoring systems and databases. Br J Anaesth. 2014;113:286–94.CrossRef
13.
Zurück zum Zitat Tohira H, Jacobs I, Mountain D, et al. Comparisons of the outcome prediction performance of injury severity scoring tools using the Abbreviated Injury Scale 90 Update 98 (AIS 98) and 2005 Update 2008 (AIS 2008). Annals of Advances in Automotive Medicine/Annual Scientific Conference. 2011. p. 255-65. Tohira H, Jacobs I, Mountain D, et al. Comparisons of the outcome prediction performance of injury severity scoring tools using the Abbreviated Injury Scale 90 Update 98 (AIS 98) and 2005 Update 2008 (AIS 2008). Annals of Advances in Automotive Medicine/Annual Scientific Conference. 2011. p. 255-65.
14.
Zurück zum Zitat Wade CE, Salinas J, Eastridge BJ, McManus JG, Holcomb JB. Admission hypo- or hyperthermia and survival after trauma in civilian and military environments. Int J Emerg Med. 2011;4:35.CrossRef Wade CE, Salinas J, Eastridge BJ, McManus JG, Holcomb JB. Admission hypo- or hyperthermia and survival after trauma in civilian and military environments. Int J Emerg Med. 2011;4:35.CrossRef
15.
Zurück zum Zitat Bengualid V, Talari G, Rubin D, Albaeni A, Ciubotaru RL, Berger J. Fever in trauma patients: evaluation of risk factors, including traumatic brain injury. Am J Crit Care. 2015;24:e1–5.CrossRef Bengualid V, Talari G, Rubin D, Albaeni A, Ciubotaru RL, Berger J. Fever in trauma patients: evaluation of risk factors, including traumatic brain injury. Am J Crit Care. 2015;24:e1–5.CrossRef
17.
Zurück zum Zitat Harrell JFE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. Harrell FE Jr., editor. New York: Springer; 2010. Harrell JFE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. Harrell FE Jr., editor. New York: Springer; 2010.
18.
Zurück zum Zitat Rincon F, Patel U, Schorr C, Lee E, Ross S, Dellinger RP, et al. Brain injury as a risk factor for fever upon admission to the intensive care unit and association with in-hospital case fatality: a matched cohort study. J Intensive Care Med. 2015;30:107–14.CrossRef Rincon F, Patel U, Schorr C, Lee E, Ross S, Dellinger RP, et al. Brain injury as a risk factor for fever upon admission to the intensive care unit and association with in-hospital case fatality: a matched cohort study. J Intensive Care Med. 2015;30:107–14.CrossRef
19.
Zurück zum Zitat Levi M. Hemostasis and thrombosis in extreme temperatures (hypo- and hyperthermia). Semin Thromb Hemost. 2018;44:651–5.CrossRef Levi M. Hemostasis and thrombosis in extreme temperatures (hypo- and hyperthermia). Semin Thromb Hemost. 2018;44:651–5.CrossRef
20.
Zurück zum Zitat Bruchim Y, Kelmer E, Cohen A, Codner C, Segev G, Aroch I. Hemostatic abnormalities in dogs with naturally occurring heatstroke. J Vet Emerg Crit Care (San Antonio). 2017;27:315–24.CrossRef Bruchim Y, Kelmer E, Cohen A, Codner C, Segev G, Aroch I. Hemostatic abnormalities in dogs with naturally occurring heatstroke. J Vet Emerg Crit Care (San Antonio). 2017;27:315–24.CrossRef
21.
Zurück zum Zitat Bouchama A, Al-Mohanna F, Assad L, Baturcam E, Eldali A, Owaidah T, et al. Tissue factor/factor VIIa pathway mediates coagulation activation in induced-heat stroke in the baboon. Crit Care Med. 2012;40:1229–366.CrossRef Bouchama A, Al-Mohanna F, Assad L, Baturcam E, Eldali A, Owaidah T, et al. Tissue factor/factor VIIa pathway mediates coagulation activation in induced-heat stroke in the baboon. Crit Care Med. 2012;40:1229–366.CrossRef
22.
Zurück zum Zitat Mustafa KY, Omer O, Khogali M, Jamjoom A, Gumaa KA, El-Nasr NA, et al. Blood coagulation and fibrinolysis in heat stroke. Br J Haematol. 1985;61:517–23.CrossRef Mustafa KY, Omer O, Khogali M, Jamjoom A, Gumaa KA, El-Nasr NA, et al. Blood coagulation and fibrinolysis in heat stroke. Br J Haematol. 1985;61:517–23.CrossRef
23.
Zurück zum Zitat Martini WZ, Pusateri AE, Uscilowicz JM, Delgado AV, Holcomb JB. Independent contributions of hypothermia and acidosis to coagulopathy in swine. J Trauma. 2005;58:1002–9 (discussion 9–10).CrossRef Martini WZ, Pusateri AE, Uscilowicz JM, Delgado AV, Holcomb JB. Independent contributions of hypothermia and acidosis to coagulopathy in swine. J Trauma. 2005;58:1002–9 (discussion 9–10).CrossRef
24.
Zurück zum Zitat Mitrophanov AY, Rosendaal FR, Reifman J. Computational analysis of the effects of reduced temperature on thrombin generation: the contributions of hypothermia to coagulopathy. Anesth Analg. 2013;117:565–74.CrossRef Mitrophanov AY, Rosendaal FR, Reifman J. Computational analysis of the effects of reduced temperature on thrombin generation: the contributions of hypothermia to coagulopathy. Anesth Analg. 2013;117:565–74.CrossRef
Metadaten
Titel
Body temperature and in-hospital mortality in trauma patients: analysis of a nationwide trauma database in Japan
verfasst von
Asami Okada
Yohei Okada
Hiromichi Narumiya
Wataru Ishii
Tetsuhisa Kitamura
Ryoji Iiduka
Publikationsdatum
14.09.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 1/2022
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01489-9

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