Purpose Patients with advanced heart failure have disordered thermoregulation. Whether lower body temperatures are associated with worse survival is uncertain.
Methods We used data on 56,659 patients 65 years or older from the National Heart Care (NHC) Project. In addition to clinical data, admission body temperature was recorded. Patients were grouped a priori into 3 categories based on body temperature: 1)<36°C, 2) 36°C to 38°C, and 3)>38°C. Survey logistic regression and fractional polynomial logistic regression were used to determine the independent association of body temperature with in-hospital and one-year mortality.
Results Mean body temperature in the study population was 36.5°C (± 0.005°C); 10,754 (18.5%) patients had body temperatures below 36°C while 1145 (1.9%) patients had body temperatures over 38°C. After multivariate adjustment, patients with body temperatures below 36°C had higher in-hospital (adjusted risk ratio [RR], 1.28; p<0.001) and one-year mortality (adjusted RR, 1.14; p<0.001) when compared to patients with body temperatures between 36°C and 38°C. Body temperatures above 38°C had no significant relationship with in-hospital death, but were associated with a lower one-year mortality (adjusted RR, 0.80; p = 0.001). Our findings were consistent across several patient subgroups. Lower body temperatures were associated with increased mortality as body temperatures fell below 37°C (Figure).
Conclusions Admission body temperatures below 36°C are independently associated with worse survival in heart failure. Given that body temperature is easily measured and widely available, it may improve risk assessment in these patients.
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