Cat body temperature at emergency admission predicts survival outcomes

Abstract

Objectives The aim of the study was to evaluate the association between triage body temperature (BT) and outcome in cats presenting to the emergency department (ED). Methods A retrospective observational study was conducted on cats presented to the ED. BT, clinical diagnosis and outcome were recorded. BT was categorised as follows: normothermia (37.8–39.7°C); hyperthermia (⩾39.8°C); mild hypothermia (36.8–37.7°C); moderate hypothermia (35.6–36.7°C); severe hypothermia (33.1–35.5°C); and critical hypothermia (⩽33°C). Outcome in the ED was categorised as death, euthanasia, hospital admission and discharge. Outcome at hospital discharge was evaluated in patients admitted to the intensive care unit (ICU). Systemic inflammatory response syndrome (SIRS) was identified in patients. No-SIRS cats were divided into three disease categories (urinary system, cardiovascular and miscellanea) and SIRS cats into four categories (urinary system, cardiovascular, trauma and miscellanea). The presence of sepsis was evaluated. Non-parametric statistics were used. Results A total of 1440 cats were included. The hospital mortality rate was 21.9%. Hypothermia in the ED was reported in 510 (35.4%) cats, normothermia in 849 (59%) cats and hyperthermia in 81 (5.6%) cats. In the ED, the median temperature in non-survivors (35.4°C, 95% confidence interval [CI] 34.6–36.3) was significantly lower than in survivors (38.2°C, 95% CI 38.1–38.3; P <0.0001). The risk of non-survival in the ED was significantly higher in cats with a decreased BT, progressively increasing with the severity of hypothermia ( P <0.0001). Furthermore, BT was significantly associated with a higher risk of mortality in the ICU ( P <0.0001). A diagnosis of sepsis was associated with a high prevalence of hypothermia (79/124 cats, 63.7%) and a higher risk of non-survival (odds ratio [OR] 2.62, 95% CI 1.52–4.54; P  = 0.0006). The mortality risk significantly increased in SIRS cats with a cardiovascular disease (OR 8.27, 95% CI 4.09–16.68; P <0.0001). Conclusions and relevance Hypothermia is common in cats at ED admission and is significantly associated with outcome. Triage hypothermia might identify patients with sepsis or SIRS complicated by comorbidities, such as cardiovascular and urinary diseases.