Body Temperature as a Predictor of Mortality in Multiple Trauma Patients: A Prospective Single-Centre Cohort Study

Background 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 experiencing cold stress. Methods 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. Bivariate and multivariate 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. Results The study comprised 334 patients, with an overall mortality rate of 10.4%. Hypothermia (BT < 35°C) was observed in 11.7% of patients, resulting in a mortality rate of 25%. Patients experiencing cold stress (35–37°C) constituted 75.1% of the cohort. Bivariate 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 for patients experiencing cold stress (OR 3.29; 95%CI: 1.23–8.77; P = 0.017). Conclusions 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 who experienced cold stress with a BT < 36°C exhibited a threefold elevated probability of mortality. Clinical trial number: not applicable.