ArticleScandinavian journal of trauma, resuscitation and emergency medicine2026
Prognostic impact of body temperature trajectories from emergency department arrival to intensive care unit admission - insights from the TraumaRegister DGU
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHypothermia is a significant and independent predictor of mortality in patients with severe trauma and constitutes a key component of the trauma-related lethal triad, along with acidosis and coagulopathy. While the prognostic impact of hypothermia at isolated time points is well established, the clinical relevance of dynamic body temperature changes during the early in-hospital phase remains poorly understood. This study aims to evaluate the association between body temperature trajectories from emergency department (ED) admission to intensive care unit (ICU) transfer and clinical outcomes in major trauma patients.
methodsRetrospective data from the TraumaRegister DGU
resultsA total of 34,877 patients met the inclusion criteria (mean age 54.2 ± 20.9 years; 71.6% male; mean ISS 22.8 ± 11.5). Hypothermia was present in 10.7% upon ED admission and 9.7% of patients at ICU transfer. Persistent hypothermia was associated with the highest mortality (43.5%), coagulopathy (28.2%), and transfusion rates (31.8%). New onset of hypothermia in the ICU was also linked to poor prognosis (mortality 31.9%). Patients with a temperature decrease (11.2%) had significantly higher injury severity and mortality compared to those with stable or rising temperatures. Female patients were disproportionately represented in hypothermic ICU groups (38%).
conclusionHypothermia-particularly when persistent or newly acquired-emerges as a strong predictor of adverse outcomes in trauma patients. Dynamic temperature monitoring between ED and ICU provides critical prognostic insights that extend beyond static measurements. Early identification and management of thermal dysregulation, including sex-specific considerations, should be integral components of contemporary trauma care protocols.
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