The Risk of Rectal Temperature Measurement in Neutropenia
Background: Avoiding rectal thermometry is recommended in patients with neutropenic fever. Permeability of the anal mucosa may result in a higher risk of bacteremia in these patients. Still, this recommendation is based on only a few studies. Methods: This retrospective study included all individ...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Rambam Health Care Campus
2023-07-01
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| Series: | Rambam Maimonides Medical Journal |
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| Online Access: | https://www.rmmj.org.il/issues/59/1580/manuscript |
| _version_ | 1797755338876780544 |
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| author | Judith Olchowski Noa Zimhony-Nissim Lior Nesher Leonid Barski Elli Rosenberg Iftach Sagy |
| author_facet | Judith Olchowski Noa Zimhony-Nissim Lior Nesher Leonid Barski Elli Rosenberg Iftach Sagy |
| author_sort | Judith Olchowski |
| collection | DOAJ |
| description | Background: Avoiding rectal thermometry is recommended in patients with neutropenic fever. Permeability of the anal mucosa may result in a higher risk of bacteremia in these patients. Still, this recommendation is based on only a few studies.
Methods: This retrospective study included all individuals admitted to our emergency department during 2014–2017 with afebrile (body temperature <38.3°C) neutropenia (neutrophil count <500 cells/microL) who were over the age of 18. Patients were stratified by the presence or absence of a rectal temperature measurement. The primary outcome was bacteremia during the first five days of index hospitalization; the secondary outcome was in-hospital mortality.
Results: The study included 40 patients with rectal temperature measurements and 407 patients whose temperatures were only measured orally. Among patients with oral temperature measurements, 10.6% had bacteremia, compared to 5.1% among patients who had rectal temperature measurements. Rectal temperature measurement was not associated with bacteremia, neither in non-matched (odds ratio [OR] 0.36, 95% confidence interval [CI] 0.07–1.77) nor in matched cohort analyses (OR 0.37, 95% CI 0.04–3.29). In-hospital mortality was also similar between the groups.
Conclusions: Patients with neutropenia who had their temperature taken using a rectal thermometer did not experience a higher frequency of events of documented bacteremia or increased in-hospital mortality. |
| first_indexed | 2024-03-12T17:46:23Z |
| format | Article |
| id | doaj.art-36487b792c1f4ce4a49e03662004e341 |
| institution | Directory Open Access Journal |
| issn | 2076-9172 |
| language | English |
| last_indexed | 2024-03-12T17:46:23Z |
| publishDate | 2023-07-01 |
| publisher | Rambam Health Care Campus |
| record_format | Article |
| series | Rambam Maimonides Medical Journal |
| spelling | doaj.art-36487b792c1f4ce4a49e03662004e3412023-08-03T16:55:06ZengRambam Health Care CampusRambam Maimonides Medical Journal2076-91722023-07-01143e001410.5041/RMMJ.10501The Risk of Rectal Temperature Measurement in NeutropeniaJudith Olchowski0Noa Zimhony-Nissim1Lior Nesher2Leonid Barski3Elli Rosenberg4Iftach Sagy5Infectious Diseases Institute, Rambam Health Care Campus, Haifa, IsraelClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Internal Medicine Division, Soroka University Medical Center, Beer-Sheva, Israel; and Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Internal Medicine Division, Soroka University Medical Center, Beer-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Internal Medicine Division, Soroka University Medical Center, Beer-Sheva, IsraelClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; and Internal Medicine Division, Soroka University Medical Center, Beer-Sheva, IsraelBackground: Avoiding rectal thermometry is recommended in patients with neutropenic fever. Permeability of the anal mucosa may result in a higher risk of bacteremia in these patients. Still, this recommendation is based on only a few studies. Methods: This retrospective study included all individuals admitted to our emergency department during 2014–2017 with afebrile (body temperature <38.3°C) neutropenia (neutrophil count <500 cells/microL) who were over the age of 18. Patients were stratified by the presence or absence of a rectal temperature measurement. The primary outcome was bacteremia during the first five days of index hospitalization; the secondary outcome was in-hospital mortality. Results: The study included 40 patients with rectal temperature measurements and 407 patients whose temperatures were only measured orally. Among patients with oral temperature measurements, 10.6% had bacteremia, compared to 5.1% among patients who had rectal temperature measurements. Rectal temperature measurement was not associated with bacteremia, neither in non-matched (odds ratio [OR] 0.36, 95% confidence interval [CI] 0.07–1.77) nor in matched cohort analyses (OR 0.37, 95% CI 0.04–3.29). In-hospital mortality was also similar between the groups. Conclusions: Patients with neutropenia who had their temperature taken using a rectal thermometer did not experience a higher frequency of events of documented bacteremia or increased in-hospital mortality.https://www.rmmj.org.il/issues/59/1580/manuscriptbacteremianeutropenic feverrectal thermometry |
| spellingShingle | Judith Olchowski Noa Zimhony-Nissim Lior Nesher Leonid Barski Elli Rosenberg Iftach Sagy The Risk of Rectal Temperature Measurement in Neutropenia Rambam Maimonides Medical Journal bacteremia neutropenic fever rectal thermometry |
| title | The Risk of Rectal Temperature Measurement in Neutropenia |
| title_full | The Risk of Rectal Temperature Measurement in Neutropenia |
| title_fullStr | The Risk of Rectal Temperature Measurement in Neutropenia |
| title_full_unstemmed | The Risk of Rectal Temperature Measurement in Neutropenia |
| title_short | The Risk of Rectal Temperature Measurement in Neutropenia |
| title_sort | risk of rectal temperature measurement in neutropenia |
| topic | bacteremia neutropenic fever rectal thermometry |
| url | https://www.rmmj.org.il/issues/59/1580/manuscript |
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