Evidence map›Paper›PMID 34423134›Full record

ArticleTrauma surgery & acute care open2021

Chronic critical illness after hypothermia in trauma patients.

David Miranda, Rebecca Maine, Mackenzie Cook, Scott Brakenridge, Lyle Moldawer, Saman Arbabi, Grant O'Keefe, Bryce Robinson, Eileen M Bulger, Ronald Maier and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

David MirandaDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Rebecca MaineDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Mackenzie CookDepartment of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Scott BrakenridgeDepartment of Surgery, University of Florida, Gainesville, Florida, USA.
Lyle MoldawerDepartment of Surgery, University of Florida, Gainesville, Florida, USA.
Saman ArbabiDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Grant O'KeefeDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Bryce RobinsonDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Eileen M BulgerDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Ronald MaierDepartment of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Joseph CuschieriSurgery at ZSFG, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0003-1456-6841
University of Washington · USUniversity of Florida · USOregon Health & Science University · USUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesChronic critical illness (CCI) is a phenotype that occurs frequently in patients with severe injury. Previous work has suggested that inflammatory changes leading to CCI occur early following injury. However, the modifiable factors associated with CCI are unknown. We hypothesized that hypothermia, an early modifiable factor, is associated with CCI.

methodsTo determine the association of hypothermia and CCI, a secondary analysis of the Inflammation and Host Response to Injury database was performed, and subsequently validated on a similar cohort of patients from a single level 1 trauma center from January 2015 to December 2019. Hypothermia was defined as initial body temperature ≤34.5°C. CCI was defined as death or sustained multiorgan failure ≥14 days after injury. Data were analyzed using univariable analyses with Student's t-test and Pearson's χ

resultsOf the initial 1675 patients, 254 had hypothermia and 1421 did not. On univariable analysis, 120/254 (47.2%) of patients with hypothermia had CCI, compared with 520/1421 (36.6%) without hypothermia who had CCI, p<0.001. On multivariable logistic regression, hypothermia was independently associated with CCI, OR 1.61 (95% CI 1.17 to 2.21) but not mortality. Subsequent validation in 1264 patients of which 172 (13.6%) were hypothermic, verified that hypothermia was independently associated with CCI on multivariable logistic regression, OR 1.84 (95% CI 1.21 to 2.41). Transcriptomic analysis in hypothermic and non-hypothermic patients revealed unique cellular-specific genomic changes to only circulating monocytes, without any distinct effect on neutrophils or lymphocytes.

conclusionsHypothermia is associated with the development of CCI in severely injured patients. There are transcriptomic changes which indicate that the changes induced by hypothermia may be associated with persistent CCI. Thus, early reversal of hypothermia following injury may prevent the CCI. LEVEL OF EVIDENCE: III.

Indexed as

multiple organ failuremultiple trauma

Identifiers

PMID34423134
PMCPMC8323397
OpenAlexW3192363263

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.