Abstract
Background
Temperature measurement plays a central role in determining pediatric patients' disease
risk and management. However, current pediatric temperature thresholds may be outdated
and not applicable to children.
Objective
To characterize pediatric temperature norms and variation by patient characteristics,
time of measurement, and thermometer route.
Methods
In this cross-sectional study, we analyzed 134,641 well-child visits occurring between
2014-2019 at primary care clinics that routinely measured temperature. We performed
bivariate and multivariable quantile regressions with clustered standard errors to
determine temperature percentiles and variation by age, sex, time of measurement,
and thermometer route. We performed sensitivity analyses: 1) using a cohort that excluded
visits with infectious diagnoses that could explain temperature aberrations and 2)
including clinic as a fixed effect.
Results
The median rectal temperature for visits of infants ≤12 months old was 37.2˚C, which
was 0.4˚C higher than the median axillary temperature. The median axillary temperature
for children 1–18 years old was 36.7˚C, which was 0.1˚C lower than the median values
of all other routes. The 99th percentile for rectal temperatures in infants was 37.8˚C
and the 99.9th percentile for axillary temperatures in children was 38.5˚C. Adjusted
analyses did not demonstrate clinically significant variation in temperature by sex,
age, or time of measurement.
Conclusions
These updated temperature norms can serve as reference values in clinical practice
and should be considered in the context of thermometer route used and the clinical
condition being evaluated. Variations in temperature values by sex, age, and time
of measurement were not clinically significant.
Keywords
Abbreviations:
STARR (Stanford Research Repository), EMR (electronic medical record), BMI (body mass index), kg (kilograms, in, inches), CI (confidence intervals), IQR (interquartile range), Center for Disease Control & Prevention ACIP (Advisory Committee on Immunization Practices)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 28, 2022
Accepted:
July 22,
2022
Received:
April 15,
2022
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
