Evidence map›Paper›PMID 40524120›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2025

Association between postoperative body temperature and in-hospital mortality: a nationwide cohort study of 157,028 critically ill patients in Japan.

Yoshitaka Aoki, Mikio Nakajima, Soichiro Mimuro, Ryo Imai, Takayuki Katsuragawa, Kensuke Kobayashi, Hiromi Kato, Hiroshi Makino, Yoshiki Nakajima

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Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. 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
–field-weighted citation impact
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

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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.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yoshitaka AokiDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan. ysyaoki27@gmail.com.ORCID 0000-0002-3750-4160
Mikio NakajimaEmergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
Soichiro MimuroDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Ryo ImaiDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Takayuki KatsuragawaDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Kensuke KobayashiDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Hiromi KatoDepartment of Anesthesiology, Paul Brousse Hospital, Paris-Saclay University, Paris, France.
Hiroshi MakinoDepartment of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Hokkaido, Japan.
Yoshiki NakajimaDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.

Funding

Research Support, Non-US Gov’t
6 · The paper itself

Abstract

purposeThe association between postoperative body temperature and in-hospital mortality remains unclear. We sought to evaluate this association across all surgical patients and assessed whether it is affected by the indication for surgery (i.e., surgical source control of infection vs other indications).

methodsIn a nationwide cohort study, we included critically ill adult patients registered in the Japanese Intensive Care Patient Database who underwent surgery between 2015 and 2021. We evaluated whether the body temperature was associated with in-hospital mortality, and if a differential effect was observed in patients who underwent surgery for source control of infection vs other indications (control group). We categorized the highest body temperatures recorded in the 24 hr after admission following surgery in 0.5-°C intervals and evaluated them using multivariable regression. We conducted a subgroup analysis of patients who underwent surgery for infection control vs other indications. We report the summary estimates using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). We examined the association between body temperature category and in-hospital mortality using cubic spline models to assess nonlinear associations.

resultsAmong 157,028 patients, the overall in-hospital mortality was 2.9%. We observed a U-shaped association of temperature and mortality, with increased mortality at body temperatures < 36.0 °C (OR, 2.15; 95% CI, 1.62 to 2.86) and > 40.0 °C (OR, 1.41; 95% CI, 1.02 to 1.96). We observed the lowest mortality at 37.5-37.9 °C (OR, 0.62; 95% CI, 0.55 to 0.70). Low body temperatures were associated with increased mortality regardless of the presence or absence of infection, while high body temperatures were not associated with increased mortality in patients undergoing surgery for source control of infection.

conclusionsIn this large nationwide cohort of critically ill surgical patients in Japan, we observed that low and high postoperative body temperatures were associated with increased in-hospital mortality. Nevertheless, we did not observe the association with high body temperature and increased mortality in the subgroup of patients having undergone surgery for infection control.

Indexed as

Body TemperatureCritical IllnessHospital MortalityAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleHumansJapanMaleMiddle AgedPostoperative Periodbody temperaturefeverhospital mortalityhypothermiainfection controlpostoperative period

Identifiers

PMID40524120

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Registered trials

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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.