Body temperature as a predictor of mortality in multiple trauma patients: a prospective single-centre cohort study

TL;DR

Lower body temperature in multiple trauma patients is strongly linked to higher mortality, with significant risk increases for those below 36°C.

Contribution

This study demonstrates that body temperature is an independent predictor of mortality in multiple trauma patients.

Findings

Hypothermia (BT < 35°C) was associated with a 23% mortality rate compared to 10.4% overall.

For every 1°C decrease in BT, the odds of mortality increased by 72%.

A BT < 36°C was an independent predictor of mortality, tripling the risk.

Abstract

Trauma is the leading cause of death among working-age people. Individuals who have experienced trauma are more susceptible to developing accidental hypothermia. This condition has been demonstrated to be associated with poor clinical outcomes. The primary objective of this study was to identify the association between body temperature (BT) and mortality in patients with multiple trauma. A secondary objective was to ascertain whether this association remained significant in patients with body temperature < 36 °C. A prospective cohort study was conducted in a level-3-trauma centre in Barcelona, Spain, between August 2022 and February 2024. Data pertaining to demographics, out-of-hospital and in-hospital clinical variables were collected. BT was categorised as follows: <35 °C, 35–35.9 °C, 36–37 °C, and > 37 °C. Univariable and multivariable logistic regression were conducted to assess the association between BT and mortality. A sensitivity analysis was also performed using a dichotomous BT threshold of < 36 °C. The study comprised 334 patients, with an overall mortality rate of 10.4%. Secondary mortality endpoints were: 24-hour mortality in 6 patients (1.8%), 30-day mortality in 23 patients (6.9%), and in-hospital mortality in 25 patients (7.5%). Hypothermia (BT < 35 °C) was observed in 11.7% of patients, resulting in a mortality rate of 23%. Patients with BT < 36 °C constituted 43.4% of the cohort. Univariable logistic regression revealed a significant inverse relationship between BT and mortality (OR 0.51, 95% CI 0.3–0.7; P < 0.001). Following multivariable adjustment, the association remained robust (OR 0.58, 95% CI 0.37–0.91; P = 0.02). A subsequent sensitivity analysis demonstrated that a BT < 36 °C was an independent predictor of mortality (OR 3.29; 95% CI: 1.23–8.77; P = 0.017). BT was identified as an independent and significant predictor of mortality in patients with multiple trauma. For every 1 °C decrease in BT, the odds of mortality increased by 72%. Patients with a BT < 36 °C exhibited a threefold elevated probability of mortality.

The online version contains supplementary material available at 10.1038/s41598-026-35372-1.

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