Monitoring skin temperature at the wrist in hospitalised patients may assist in the detection of infection

Intern Med J. 2020 Jun;50(6):685-690. doi: 10.1111/imj.14748. Epub 2020 May 5.

Abstract

Background: Measuring temperature has always been a key observation in the diagnosis of infection. No studies have examined the usefulness of measuring temperature at the wrist to detect infection.

Aim: We sought to determine whether a watch measuring wrist temperature could accurately identify patients who are infected.

Methods: Prospective cross-sectional pilot study of temperature monitoring in an unselected patients in a tertiary referral adult nephrology unit.

Results: One hundred and four data recording sessions revealed 88 useful data sets, with recording failures in the others. Patients were retrospectively classified as having no infection (Group A, n = 60), clinically diagnosed infection with less than 24 h of treatment with antibiotics (Group B, n = 5), and clinically diagnosed infection with greater than 24 h on antibiotics (Group C, n = 23). There was a significantly higher average maximum temperature in Group B (mean (SEM)) 38°C (0.6) compared with Groups A (36.1°C (0.1)) and C (36.3°C (0.3)). Based on receiver operating characteristics (ROC) a cut-off temperature of ≥37.5°C gave sensitivity 80% and specificity 98%. Mean electrodermal activity was significantly higher in Groups B and C.

Conclusions: ROC of peripheral skin temperature measurements suggest that such a device may identify many patients requiring treatment for infection. This proof of principle study showed value in using a wearable device in the detection of infection and its potential as an early warning or monitoring device.

Keywords: fever; infection; monitoring; sepsis; temperature.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Humans
  • Pilot Projects
  • Prospective Studies
  • ROC Curve
  • Retrospective Studies
  • Skin Temperature*
  • Wrist*