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  Fever and hypothermia represent two populations of sepsis patients and are associated with outside temperature

Thomas-Rüddel, D. O., Hoffmann, P., Schwarzkopf, D., Scheer, C., Bach, F., Komann, M., Gerlach, H., Weiss, M., Lindner, M., Rüddel, H., Simon, P., Kuhn, S.-O., Wetzker, R., Bauer, M., Reinhart, K., Bloos, F. (2021): Fever and hypothermia represent two populations of sepsis patients and are associated with outside temperature. - Critical Care, 25, 368.
https://doi.org/10.1186/s13054-021-03776-2

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 Creators:
Thomas-Rüddel, Daniel O.1, Author
Hoffmann, Peter2, Author              
Schwarzkopf, Daniel1, Author
Scheer, Christian1, Author
Bach, Friedhelm1, Author
Komann, Marcus1, Author
Gerlach, Herwig1, Author
Weiss, Manfred1, Author
Lindner, Matthias1, Author
Rüddel, Hendrik1, Author
Simon, Philipp1, Author
Kuhn, Sven-Olaf1, Author
Wetzker, Reinhard1, Author
Bauer, Michael1, Author
Reinhart, Konrad1, Author
Bloos, Frank1, Author
Affiliations:
1External Organizations, ou_persistent22              
2Potsdam Institute for Climate Impact Research, ou_persistent13              

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 Abstract: Background: Fever and hypothermia have been observed in septic patients. Their influence on prognosis is subject to ongoing debates. Methods: We did a secondary analysis of a large clinical dataset from a quality improvement trial. A binary logistic regression model was calculated to assess the association of the thermal response with outcome and a multinomial regression model to assess factors associated with fever or hypothermia. Results: With 6542 analyzable cases we observed a bimodal temperature response characterized by fever or hypothermia, normothermia was rare. Hypothermia and high fever were both associated with higher lactate values. Hypothermia was associated with higher mortality, but this association was reduced after adjustment for other risk factors. Age, community-acquired sepsis, lower BMI and lower outside temperatures were associated with hypothermia while bacteremia and higher procalcitonin values were associated with high fever. Conclusions: Septic patients show either a hypothermic or a fever response. Whether hypothermia is a maladaptive response, as indicated by the higher mortality in hypothermic patients, or an adaptive response in patients with limited metabolic reserves under colder environmental conditions, remains an open question. Trial registration The original trial whose dataset was analyzed was registered at ClinicalTrials.gov (NCT01187134) on August 23, 2010, the first patient was included on July 1, 2011.

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Language(s): eng - English
 Dates: 2021-09-292021-10-212021
 Publication Status: Finally published
 Pages: 10
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: MDB-ID: yes - 3303
PIKDOMAIN: RD2 - Climate Resilience
Organisational keyword: RD2 - Climate Resilience
Working Group: Hydroclimatic Risks
Research topic keyword: Health
Research topic keyword: Weather
Regional keyword: Germany
Regional keyword: Brandenburg
Model / method: Open Source Software
OATYPE: Gold Open Access
DOI: 10.1186/s13054-021-03776-2
 Degree: -

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Title: Critical Care
Source Genre: Journal, SCI, Scopus, oa
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Pages: - Volume / Issue: 25 Sequence Number: 368 Start / End Page: - Identifier: CoNE: https://publications.pik-potsdam.de/cone/journals/resource/critical-care
Publisher: BioMed Central (BMC)