Association of Admission Temperature and Outcome among Neonates with Sepsis in a Tertiary Care Hospital

Abstract

Background: Neonatal sepsis is a leading cause of mortality in the neonatal period, particularly in low- and middle-income countries. Temperature at admission may provide valuable prognostic information for managing critically ill neonates. Objective: This study aimed to determine the association between admission temperature and outcomes in neonates with sepsis, including mortality rates, length of hospital stay, and the requirement for intensive interventions. Methods: This descriptive cross-sectional study was conducted from July 2022 to February 2023 in the Department of Paediatrics, Combined Military Hospital, Kharian. A total of 170 neonates diagnosed with sepsis were enrolled using non-probability, consecutive sampling. Informed, written consent was obtained from parents or guardians. Temperature was recorded at admission using a mercury thermometer in the axilla. Hypothermia was defined as a body temperature <36.5°C, hyperthermia as >37.5°C, and normothermia as 36.5-37.5°C. Blood and urine samples were collected for culture. Data were analyzed using SPSS version 25. Quantitative variables were expressed as mean ± standard deviation or median with interquartile range, and qualitative variables as frequencies and percentages. Comparisons were made using Chi-square, Fisher’s exact test, ANOVA, and independent samples t-test, with a significance level of p ≤ 0.05. Results: Of the 170 neonates, 94 (55.3%) were male and 76 (44.7%) were female. Hypothermia was present in 50 (29.4%) neonates, normothermia in 35 (20.6%), and hyperthermia in 85 (50.0%). Blood culture positivity was highest in hyperthermic neonates (61.2%), followed by hypothermic (36.0%) and normothermic (17.1%) neonates (p < 0.001). The mean length of hospital stay was 13.1 ± 4.1 days for hyperthermic neonates, 9.1 ± 2.3 days for hypothermic, and 6.3 ± 2.9 days for normothermic neonates (p < 0.001). Mortality rates were 31.8% for hyperthermic neonates, 14.0% for hypothermic, and 5.7% for normothermic (p = 0.002). Conclusion: Admission temperature in neonates with sepsis is significantly associated with clinical outcomes. Hyperthermic neonates have higher mortality rates, increased blood culture positivity, and longer hospital stays compared to normothermic and hypothermic neonates. Measuring body temperature at admission can aid in risk stratification and management decisions.