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Complex and plausible patho-physiological mechanisms are discussed by the authors with regards to significant variation in normal body temperature and the risk of increased mortality with elevated temperature (1).
But there could be a simpler explanation for the increased mortality and raised temperature noted particularly in African- American women attending an emergency department. Did the authors adjust the mortality data for insurance coverage and economic deprivation based on patients’ home zip code? (2).
Socio-economic deprivation and lack of insurance coverage could have been responsible for the observed increased mortality with the raised temperature being a mere surrogate marker for undiagnosed medical comorbidities .(3).
1. Obermeyer Ziad, Samra Jasmeet K, Mullainathan Sendhil. Individual differences in normal body temperature: longitudinal big data analysis of patient records BMJ 2017; 359 :j5468. doi: https://doi.org/10.1136/bmj.j5468
2. Haider AH, Chang DC, Efron DT, Haut ER, Crandall M, Cornwell EE 3rd. Race and insurance status as risk factors for trauma mortality. doi: 10.1001/archsurg.143.10.945.
3. Duron VP, Monaghan SF, Connolly MD, Gregg SC, Stephen AH, Adams CA Jr, Cioffi WG, Heffernan DS. Undiagnosed medical comorbidities in the uninsured: a significant predictor of mortality following trauma. J Trauma Acute Care Surg. 2012 Nov;73(5):1093-8; doi: 10.1097/TA.0b013e31826fc844.