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Predictive value of toe-to-room temperature gradient for 28 d mortality in sepsis patients: a single center prospective observational clinical study
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Lu-Lan Li1, Yi-Lin Liu2, Yong Liu3, Shao-Wu Chen4, Hong-Bin Hu1, Zhen-Hua Zeng1, *
Medical Journal of Chinese People’s Liberation Army | 2025, 50(5) : 536 - 544
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Medical Journal of Chinese People’s Liberation Army | 2025, 50(5): 536-544
Clinical Research
Predictive value of toe-to-room temperature gradient for 28 d mortality in sepsis patients: a single center prospective observational clinical study
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Lu-Lan Li1, Yi-Lin Liu2, Yong Liu3, Shao-Wu Chen4, Hong-Bin Hu1, Zhen-Hua Zeng1, *
Affiliations
  • 1Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
  • 2Department of Critical Care Medicine, Yuebei People's Hospital, Shaoguan, Guangdong 512000, China
  • 3Department of Critical Care Medicine, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong 518101, China
  • 4Department of Critical Care Medicine, Yunfu People's Hospital, Yunfu, Guangdong 527399, China
Published: 2025-05-28 doi: 10.11855/j.issn.0577-7402.0620.2025.0114
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Objective To investigate the predictive value of temperature gradients on the mortality of sepsis patients and their correlation with fluid input. Methods By means of a prospective observational method, 154 patients with sepsis or septic shock admitted to the Department of Critical Care Medicine at Nanfang Hospital, Southern Medical University from November 2019 to November 2021 were included as research subjects. They were divided into a survivor group (n=118) and a non-survivor group (n=36) according to whether they survived within 28 days. The core-to-toe temperature gradient (CTTG) and toe-to-room temperature gradient (TRTG) were monitored and calculated immediately upon admission to the intensive care unit (ICU) and 6 hours after admission. Receiver operating characteristic (ROC) curve was used to explore the predictive value of temperature gradients on mortality, and multivariate Cox regression analysis was performed to explore the risk factors of 28-day mortality in sepsis patients. The results were verified through survival analysis. Correlation analysis and multivariate analysis of variance were used to explore the correlation between temperature gradients and fluid input, as well as noradrenaline doses. Results Among the 154 patients, 118 survived within 28 days (survivor group), and 36 died (non-survivor group). ROC curve and multivariate Cox regression analysis showed that a toe-to-room temperature gradient of ≤5.35 ℃ within 6 hours after admission was a risk factor for 28-day mortality. Compared with patients with a high toe-to-room temperature gradient (>5.35 ℃), patients with a low toe-to-room temperature gradient (≤5.35 ℃) had a 2.74-fold increase in the risk of 28-day mortality (P=0.004, 95%CI 1.54, 9.12). The CTTG and TRTG upon admission to the ICU and 6 hours after admission were not significantly associated with fluid input or noradrenaline doses (P>0.05). Conclusions A toe-to-room temperature gradient of less than or equal to 5.35 ℃ within 6 hours after ICU admission is a risk factor for 28-day mortality in sepsis patients. The improvement of temperature gradients at different time points is not associated with fluid input.

sepsis  /  temperature gradient  /  fluid resuscitation  /  skin temperature
Lu-Lan Li, Yi-Lin Liu, Yong Liu, Shao-Wu Chen, Hong-Bin Hu, Zhen-Hua Zeng. Predictive value of toe-to-room temperature gradient for 28 d mortality in sepsis patients: a single center prospective observational clinical study[J]. Medical Journal of Chinese People’s Liberation Army, 2025 , 50 (5) : 536 -544 . DOI: 10.11855/j.issn.0577-7402.0620.2025.0114
  • Clinical Research Special Foundation of Nanfang Hospital, Southern Medical University(2018CR047)
  • Clinical Research Special Grant Fund of Wu Jie-Ping Medical Foundation(320.6750.18431)
Year 2025 volume 50 Issue 5
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Article Info
doi: 10.11855/j.issn.0577-7402.0620.2025.0114
  • Receive Date:2024-05-10
  • Online Date:2025-10-29
  • Published:2025-05-28
Article Data
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History
  • Received:2024-05-10
  • Accepted:2024-11-19
Funding
Clinical Research Special Foundation of Nanfang Hospital, Southern Medical University(2018CR047)
Clinical Research Special Grant Fund of Wu Jie-Ping Medical Foundation(320.6750.18431)
Affiliations
    1Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
    2Department of Critical Care Medicine, Yuebei People's Hospital, Shaoguan, Guangdong 512000, China
    3Department of Critical Care Medicine, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong 518101, China
    4Department of Critical Care Medicine, Yunfu People's Hospital, Yunfu, Guangdong 527399, China

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表12种不同金属材料的力学参数

Family
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Number of
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种数
Number of
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种数
Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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