基于MIMIC数据库分析体温对ICU充血性心力衰竭患者预后的预测价值  

The association between temperature and in-hospital mortality in patients with congestive heart failure:a retrospective cohort study based on the MIMIC-IV database

作　　者：王希 周翔[2] 罗红波 赵明曦 李尊柱 井杰 李莫言 陈天超 孙建华 Wang Xi;Zhou Xiang;Luo Hongbo;Zhao Mingxi;Li Zunzhu;Jing Jie;Li Moyan;Chen Tianchao;Sun Jianhua(Department of Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Information Offi ce,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nursing,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Medicine ICU,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院重症医学科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院信息中心,北京100730 [3]中国医学科学院北京协和医学院北京协和医院护理部,北京100730 [4]中国医学科学院北京协和医学院北京协和医院内科ICU,北京100730

出　　处：《中国医刊》2025年第1期27-30,共4页Chinese Journal of Medicine

基　　金：北京协和医院护理科研基金(XHHLKY202305);北京协和医院第1期青年拔尖人才培养项目(UBJ10777)。

摘　　要：目的探讨充血性心力衰竭(CHF)患者入ICU后首次体温与住院死亡率的相关性,以期为临床体温管理提供借鉴。方法采用回顾性队列研究的方法,提取MIMIC-IV数据库中的CHF患者,应用logistic回归、广义加性模型、logistic曲线拟合等评估入ICU后首次体温与住院死亡率之间的关系。结果共纳入15983例CHF患者,平均年龄(72.9±13.4)岁,其中男性占54.6%;CHF患者入ICU期间死亡率为12.4%。Logistic回归分析显示,CHF患者入ICU后首次体温与住院死亡风险独立相关(OR=0.67,95%CI 0.62~0.74,P<0.001);曲线拟合结果显示CHF患者入ICU后首次体温与住院死亡风险呈U形曲线关系,体温拐点是36.7℃。分段Cox回归模型显示,当入ICU后首次体温小于36.7℃时,体温与住院死亡风险呈显著负相关(OR=0.698,95%CI 0.497~0.981,P=0.0385)。相反,当入ICU后首次体温大于36.7℃时,体温与住院死亡风险显著正相关(OR=1.541,95%CI 1.378~2.398,P=0.0437)。结论CHF患者入ICU后首次体温与住院期间死亡风险之间的关系是非线性的,呈U形曲线。较高和较低的入ICU后首次体温均与住院死亡率升高有关。Objective To study the correlation between admission body temperature and in-hospital mortality in patients with congestive heart failure(CHF).Method A retrospective cohort study was conducted on CHF patients from the MIMIC-IV database,using binary logistic regression,generalized additive models,and logistic curve fi tting to evaluate the relationship between temperature and in-hospital mortality.Result A total of 15983 CHF patients were included,with an average age of(72.9±13.4)years,of which 54.6%were male,and the in-hospital mortality rate was 12.4%.The admission body temperature in CHF patients was independently associated with the risk of in-hospital mortality(OR=0.67,95%CI 0.62-0.74,P<0.001).The curve fi tting results showed a U-shaped relationship between admission body temperature and in-hospital mortality,with a turning point at 36.7℃.When the body temperature was below 36.7℃,an increase in body temperature was signifi cantly associated with a reduced risk of in-hospital mortality(OR=0.698,95%CI 0.497-0.981,P=0.0385).Conversely,when the body temperature was above 36.7℃,an increase in body temperature was signifi cantly associated with an increased risk of in-hospital mortality(OR=1.541,95%CI 1.378-2.398,P=0.0437).Conclusion The relationship between admission body temperature and in-hospital mortality risk in CHF patients was U-shaped.Both higher and lower admission body temperatures were associated with increased in-hospital mortality.

关 键 词：充血性心力衰竭 体温 住院死亡率 重症患者 

分 类 号：R541.2[医药卫生—心血管疾病]