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#Grand Rounds

Is Individual Baseline Temperature Variation Associated with Subsequent Mortality?

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BACKGROUND AND PURPOSE: 

  • Medical professionals are given ranges of ‘normal’ temperatures, but these reflect human population data and not individual variation 
    • Most studies on temperature conducted from 1950 or before  
  • There is research in fruit flies and mice that lower body temperature may be associated with longevity  
  • The modern electronic health record allows for research on a more individualized basis  
  • Obermeyer et al. (BMJ, 2017) estimated individual level body temperature and correlated this data with other physiologic and health parameters 

METHODS: 

  • Observational cohort study 
  • Dataset from large US based academic hospital  
    • Routine outpatient visits  
    • No evidence of infection or antibiotic prescriptions  
    • Temperatures within normal limits  
  • Temperature recordings controlled for ambient conditions at the time of measurement, body site, and time factors 
  • Baseline temperature was correlated with demographics, medical comorbidities, vital signs, and subsequent one year mortality 

RESULTS: 

  • 35,488 patients were included  
  • Data obtained from outpatient visits from 2009-2014 
  • 243,506 temperature measurements 
    • Mean age 52.9 years 
    • 64% women 
    • 41% non-white race 
  • Mean temperature was 36.6°C (95% range 35.7-37.3°C; 99% range 35.3-37.7°C) 
  • Older people had the coolest temperatures  
    • –0.021°C for every decade (P<0.001) 
  • African-American women had the hottest temperatures vs white men 
    • 0.052°C (P<0.001) 
  • Lower temperature was linked to many comorbidities such as hypothyroidism  
    • –0.013°C (P=0.01) 
  • Higher temperature was associated with  
    • Cancer: 0.020 (P<0.001)  
    • BMI: 0.002 per m/kg2 (P<0.001) 
  • Overall, measured factors collectively explained only 8.2% of individual temperature variation 
  • Unexplained temperature variation was a significant predictor of subsequent mortality 
    • An increase of 0.149°C (1 SD of individual temperature in the data) was linked to 8.4% higher one year mortality (P=0.014) 
    • Not associated with increase in inflammatory marker reactive protein 

CONCLUSION: 

  • Authors recognize study limitations including the fact that a single center has a single climactic zone and data based on hospital visits so potentially sicker cohort of patients than general population  
  • In this study, the authors provide an example of how ‘big data’ experiments can generate new medical knowledge  
  • Individuals’ baseline temperatures correlate with disease or other physiological measurements 
  • However, unexplained individual temperature variation correlates with a higher risk for mortality   
  • Results suggest baseline temperature could be a potential predictive tool in medicine 

Learn More – Primary Sources:  

Individual differences in normal body temperature: longitudinal big data analysis of patient records

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