Early changes in skin surface temperature predict body temperature increases in patients with fever: A pilot study

Yi-Ting Chung; Chun-Yin Yeh; Chang-Chun Chen; Chao-Han Lai; Yi-Hsuan Lin; Chung-Ying Lin; Yu-Chen Shu; Nai-Ying Ko

doi:10.1016/j.iccn.2024.103652

Early changes in skin surface temperature predict body temperature increases in patients with fever: A pilot study

Intensive Crit Care Nurs. 2024 Feb 24:83:103652. doi: 10.1016/j.iccn.2024.103652. Online ahead of print.

Authors

Yi-Ting Chung¹, Chun-Yin Yeh², Chang-Chun Chen³, Chao-Han Lai⁴, Yi-Hsuan Lin⁵, Chung-Ying Lin⁶, Yu-Chen Shu⁷, Nai-Ying Ko⁸

Affiliations

¹ Department of Nursing, National Cheng Kung University, Tainan, Taiwan.
² Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.
³ Department of Electrical and Computer Engineering, The University of Arizona, America.
⁴ Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Office of Geriatric Hospital, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Mathematics, National Cheng Kung University, Tainan, Taiwan. Electronic address: ycshu@mail.ncku.edu.tw.
⁸ Department of Nursing, National Cheng Kung University, Tainan, Taiwan. Electronic address: nyko@mail.ncku.edu.tw.

PMID: 38402650
DOI: 10.1016/j.iccn.2024.103652

Abstract

Objective: To investigate the correlation between body temperature and skin surface temperature in intensive care unit patients and to identify specific indicators of skin surface temperature for early fever detection.

Research methodology/design: This pilot study was a prospective, observational investigation conducted at National Cheng Kung University Hospital in Tainan, Taiwan. A total of 54 patients admitted to the Surgical Intensive Care Unit of a tertiary hospital between April and August 2020 were included. Patients utilized the wearable device HEARThremo^TM to continuously monitor skin surface temperature and heart rate. Analysis of Variance was applied to identify the association of skin surface temperature with different body temperature groups. The comparison between skin surface temperature and fever over eight time intervals was studied using a generalized estimating equation.

Results: In 34 patients (63 %) with a fever (≥38 °C), skin surface temperature increased (P < 0.001) when body temperature increased. The maximum skin surface temperature was significantly associated with fever 180-210 min before the fever events occurred (OR: 2.22, 95 % CI: 1.30-3.80). The mean skin surface temperature was associated with fever 120-150 min before the fever events (OR: 8.70, 95 % CI: 2.08-36.36).

Conclusions: Skin surface temperature can be an important early predictive sign before the onset of fever. Continuous temperature monitoring can detect fever early and initiate treatment in advance. This study serves as a preliminary exploration in this area, laying the groundwork for future comprehensive research.

Implications for clinical practice: Continuous monitoring of skin surface temperature empowers nurses to swiftly detect fever, transcending conventional methods. This proactive approach allows for the early identification of physiological abnormalities, facilitating the prompt initiation of further physical assessments and relevant examinations for early treatment commencement.

Keywords: Body temperature; Continuous monitoring; Fever; Skin surface temperature; Wearable device.