The Influence of Admission Body Temperature on Prognosis in Sepsis Patients: an analysis from the MIMIC-IV database

Abstract Background This study aimed to investigate the correlation between the mean body temperature during the initial 24 hours of admission and clinical outcomes in septic patients admitted to the Intensive Care Unit (ICU). Methods This retrospective observational study was conducted using data from the MIMIC-IV (v1.0) database. We extracted the average body temperature of patients with sepsis within the first 24 hours of admission to the Intensive Care Unit (ICU), along with other pertinent clinical data and hospitalization outcomes. To analyze the impact of body temperature on clinical outcomes, patients were categorized into low-temperature, normal, and hyperthermia groups based on different body temperature ranges. To minimize confounding effects, propensity score matching (PSM) was employed, ensuring comparability between the groups. The relationship between abnormal body temperature at admission and clinical outcomes was explored using univariate analysis and logistic regression models to derive robust conclusions. Results A total of 19,074 patients were included in the analysis. After adjusting for confounding factors, hypothermia (<36°C) was found to be significantly associated with higher 28-day all-cause mortality (35.27% vs. 14.08%), in-hospital mortality (37.21% vs. 15.37%), and ICU mortality (32.04% vs. 10.98%) when compared to the normal body temperature group (p < 0.05). Conversely, the hyperthermia group exhibited a significantly weaker correlation with clinical outcomes than the hypothermia. These results remained robust even after adjusting for confounding factors between the groups. Conclusion Our study suggests that a hypothermia within the initial 24 hours of admission to the ICU is significantly linked to increased mortality in patients with sepsis, whereas hyperthermia does not exhibit a similar association. Enhancing temperature monitoring during the first 24 hours after admission and avoiding overly aggressive temperature control could prove vital in improving clinical outcomes for sepsis patients.