Core-peripheral temperature gradient as a diagnostic test in dyspnoea

Emerg Med J. 2005 Sep;22(9):633-5. doi: 10.1136/emj.2004.017624.

Abstract

Objectives: To evaluate whether the core-peripheral temperature gradient could be used to distinguish between cardiac and respiratory causes of dyspnoea.

Methods: In total, 50 patients were enrolled in the study, based on the following inclusion criteria: (a) a primary presenting complaint of dyspnoea; (b) age > 40 years; (c) respiratory rate > 20 breaths/min; (d) hypoxia. The tympanic temperature and the temperature of the nasal tip were recorded, and the patient's discharge data and chest x ray results checked. Where there was discordance, arbitration was carried out by another researcher.

Results: Four patients were excluded, hence the final study sample was 46 patients. There was a statistically significant difference between the mean temperature gradients of the two study populations (p < 0.001). A gradient of > 8 degrees C was able to rule in a cardiovascular cause (92% specificity) whereas one of < 5 degrees C could rule it out (100% sensitivity).

Conclusion: The test is safe, non-invasive and inexpensive. Although there were some limitations to the study, the test can still be commended as a useful adjunct to the emergency assessment of the acutely breathless patient.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Temperature*
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / diagnosis
  • Dyspnea / etiology*
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose / physiopathology
  • Sensitivity and Specificity
  • Skin Temperature
  • Tympanic Membrane / physiopathology