Body temperature at sepsis recognition as a nursing bedside surveillance parameter: a multicenter observational cohort study.
4 affiliations
- 1Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil.
- 2Catanduva School of Medicine (FAMECA), Centro Universitário Padre Albino (UNIFIPA), Catanduva, SP, Brazil.
- 3São José do Rio Preto School of Medicine (FAMERP), São José do Rio Preto, São Paulo, SP, Brazil.
- 4Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil. [email protected].
Abstract
Background
Early recognition and surveillance of sepsis rely on timely interpretation of vital signs by nurses. Body temperature is routinely measured at bedside, but its prognostic meaning at sepsis recognition remains uncertain. This study evaluated whether body temperature at sepsis recognition was associated with hospital mortality and markers of organ dysfunction in adults with sepsis or septic shock.Methods
A multicenter observational cohort study was conducted in two Brazilian hospitals between March 2021 and January 2022. Adults with sepsis or septic shock were enrolled at sepsis protocol activation. Body temperature and other vital signs were recorded at bedside, and blood samples were collected to assess lactate, plasma nitrite/nitrate, leukocytes, platelets, creatinine, urea, and prothrombin time. Patients were classified as hypothermic (< 36.0 °C), normothermic (36.0-37.9 °C), or febrile (≥ 38.0 °C). Associations between temperature and clinical or laboratory markers were assessed using correlation analyses. Multivariable logistic regression evaluated the association between body temperature and hospital mortality after adjustment for age, sex, and sepsis severity.Results
The cohort included 166 patients; 98 (59.1%) had sepsis and 68 (40.9%) had septic shock. Overall hospital mortality was 68.1%. Non-survivors had lower body temperature and a more severe clinical and laboratory profile, including higher lactate and nitrite/nitrate concentrations, higher creatinine and urea, lower leukocyte and platelet counts, and prolonged prothrombin time. Mortality was 72.7% in hypothermic patients, 67.7% in normothermic patients, and 64.7% in febrile patients. In the adjusted model, body temperature was not independently associated with hospital mortality (odds ratio per 1 °C increase = 0.937; 95% confidence interval 0.687-1.278; P = 0.681). Older age, male sex, and septic shock were independently associated with mortality. Body temperature showed weak inverse correlations with nitrite/nitrate and prothrombin time, but no significant correlation with lactate or renal markers.Conclusions
At sepsis recognition, lower body temperature was observed among non-survivors but did not independently predict hospital mortality after adjustment for key clinical factors. For nursing practice, body temperature should be interpreted as part of integrated bedside surveillance, together with clinical deterioration and laboratory evidence of organ dysfunction, rather than as a standalone prognostic marker.
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BibTeX
@article{vieira2026body,
title = {{Body temperature at sepsis recognition as a nursing bedside surveillance parameter: a multicenter observational cohort study.}},
author = {Neireana Florêncio Vieira and Taís Pagliuco Barbosa Gregório and Natália Branco and Evelin Capellari Cárnio},
journal = {BMC nursing},
year = {2026},
month = aug,
doi = {10.1186/s12912-026-05177-8},
url = {https://europepmc.org/article/MED/42968133},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Body temperature at sepsis recognition as a nursing bedside surveillance parameter: a multicenter observational cohort study.
AU - Neireana Florêncio Vieira
AU - Taís Pagliuco Barbosa Gregório
AU - Natália Branco
AU - Evelin Capellari Cárnio
PY - 2026
DA - 2026/08/04
JO - BMC nursing
DO - 10.1186/s12912-026-05177-8
UR - https://europepmc.org/article/MED/42968133
AB - Background Early recognition and surveillance of sepsis rely on timely interpretation of vital signs by nurses. Body temperature is routinely measured at bedside, but its prognostic meaning at sepsis recognition remains uncertain. This study evaluated whether body temperature at sepsis recognition was associated with hospital mortality and markers of organ dysfunction in adults with sepsis or septic shock.Methods A multicenter observational cohort study was conducted in two Brazilian hospitals between March 2021 and January 2022. Adults with sepsis or septic shock were enrolled at sepsis protocol activation. Body temperature and other vital signs were recorded at bedside, and blood samples were collected to assess lactate, plasma nitrite/nitrate, leukocytes, platelets, creatinine, urea, and prothrombin time. Patients were classified as hypothermic (< 36.0 °C), normothermic (36.0-37.9 °C), or febrile (≥ 38.0 °C). Associations between temperature and clinical or laboratory markers were assessed using correlation analyses. Multivariable logistic regression evaluated the association between body temperature and hospital mortality after adjustment for age, sex, and sepsis severity.Results The cohort included 166 patients; 98 (59.1%) had sepsis and 68 (40.9%) had septic shock. Overall hospital mortality was 68.1%. Non-survivors had lower body temperature and a more severe clinical and laboratory profile, including higher lactate and nitrite/nitrate concentrations, higher creatinine and urea, lower leukocyte and platelet counts, and prolonged prothrombin time. Mortality was 72.7% in hypothermic patients, 67.7% in normothermic patients, and 64.7% in febrile patients. In the adjusted model, body temperature was not independently associated with hospital mortality (odds ratio per 1 °C increase = 0.937; 95% confidence interval 0.687-1.278; P = 0.681). Older age, male sex, and septic shock were independently associated with mortality. Body temperature showed weak inverse correlations with nitrite/nitrate and prothrombin time, but no significant correlation with lactate or renal markers.Conclusions At sepsis recognition, lower body temperature was observed among non-survivors but did not independently predict hospital mortality after adjustment for key clinical factors. For nursing practice, body temperature should be interpreted as part of integrated bedside surveillance, together with clinical deterioration and laboratory evidence of organ dysfunction, rather than as a standalone prognostic marker.
SN - 1472-6955
ER -