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Duration of Hypothermia is Associated with Postoperative Complications in Patients Undergoing Gynecological Surgery: A Prospective Cohort Study
- Affiliations：
1.Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing100730, China
2.Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing100730, China
- Author bio：
E-mail: easyue@163.com
- Funds：
DOI：10.24920/004419
CLC：Received：18 September 2024，
Accepted：2024-11-12，
Published Online：02 December 2024，
Published：31 December 2024
- Accepted：
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王素梅,裴丽坚,张越伦等.妇科手术患者低体温持续时间与术后并发症相关：一项前瞻性队列研究[J].中国医学科学杂志（英文）,2024,39(04):233-240.
Wang Su-Mei,Pei Li-Jian,Zhang Yue-Lun,et al.Duration of Hypothermia is Associated with Postoperative Complications in Patients Undergoing Gynecological Surgery: A Prospective Cohort Study[J].Chinese Medical Sciences Journal,2024,39(04):233-240.
王素梅,裴丽坚,张越伦等.妇科手术患者低体温持续时间与术后并发症相关：一项前瞻性队列研究[J].中国医学科学杂志（英文）,2024,39(04):233-240. DOI： 10.24920/004419.
Wang Su-Mei,Pei Li-Jian,Zhang Yue-Lun,et al.Duration of Hypothermia is Associated with Postoperative Complications in Patients Undergoing Gynecological Surgery: A Prospective Cohort Study[J].Chinese Medical Sciences Journal,2024,39(04):233-240. DOI： 10.24920/004419.
摘要
目的
2
探究妇科手术患者中低体温持续时间与术后并发症之间的关系。
方法
2
连续纳入2020年10月至2022年1月我院择期妇科手术的患者，持续监测术中核心体温变化，追踪术后早期并发症。通过线性回归模型控制潜在的混杂因素，分析术后并发症与术中低体温持续时间、最低体温小于36°C以及进入PACU或ICU时低体温状态的关联。此外，使用累积概率散点图和移动平均序列探索低体温持续时间与术后并发症率之间存在的潜在拐点。
结果
2
研究共纳入370例患者，其中193例（52.2%）出现低体温，177例（47.8%）体温正常。在这些患者中，共有92例（24.9%）发生了并发症。低体温持续时间（每增加1分钟调整后
OR
值：1.003，95%
C
I： 1.000 - 1.006，
P
= 0.047）和进入PACU或ICU时的低体温状态（调整后
OR
值：1.980，95% CI： 1.135 - 3.454，
P
= 0.016）与术后早期并发症相关。值得注意的是，随着低体温持续时间的增加，术后并发症的累积发生率呈上升趋势，且在120分钟处观察到一个潜在的拐点。
结论
2
在妇科手术中，低体温的持续时间以及进入PACU或ICU时的低体温状态与术后并发症有关。尽量缩短低体温的持续时间在临床上可能是有意义的。
Abstract
Objective
2
To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.
Methods
2
Patients who underwent elective gynecological surgery at our hospital were consecutively enrolled between October 2020 and January 2022. Core temperature was continuously monitored intraoperatively
and early postoperative complications were collected. By adjusting the logistic regression model for potential confounding factors
the association of postoperative complications with the duration of hypothermia
the lowest body temperature below 36°C
and the hypothermia upon admission to postanesthesia care unit (PACU) or intensive care unit (ICU) were analyzed. Additionally
the potential inflection point in the relationship between the duration of hypothermia and the risk of postoperative complications was explored by using cumulative probability scatter plots and moving average sequences.
Results
2
The study included 370 patients
with 193 (52.2%) experiencing hypothermia and 177 (47.8%) not. Among them
92 (24.9%) developed complications. The duration of hypothermia (adjusted odds ratio [
OR
]
for each one-minute increase: 1.003; 95% confidence interval [
CI
]
: 1.000-1.006
P
=0.047) and hypothermia upon admission to PACU or ICU (adjusted
OR
: 1.980; 95%
CI
: 1.135-3.454
P
=0.016) were associated with early postoperative complications. Notably
the cumulative incidence of postoperative complications tended to rise as the duration of hypothermia increased
with a potential inflection point observed at 120 minutes.
Conclusions
2
In gynecological surgery
the duration of hypothermia as well as hypothermia upon admission to PACU or ICU are associated with postoperative complications. Minimizing the duration of hypothermia may be clinically beneficial.
关键词
Keywords
references
Akers JL , Dupnick AC , Hillman EL , et al . Inadvertent perioperative hypothermia risks and postoperative complications: a retrospective study . AORN J 2019 ; 109 ( 6 ): 741 - 7 . doi: 10.1002/aorn.12696 http://dx.doi.org/10.1002/aorn.12696 .
Constantine RS , Kenkel M , Hein RE , et al . The impact of perioperative hypothermia on plastic surgery outcomes: a multivariate logistic regression of 1062 cases . Aesthet Surg J 2015 ; 35 ( 1 ): 81 - 8 . doi: 10.1093/asj/sju022 http://dx.doi.org/10.1093/asj/sju022 .
Epstein RH , Dexter F , Hofer IS , et al . Perioperative temperature measurement considerations relevant to reporting requirements for national quality programs using data from anesthesia information management systems . Anesth Analg 2018 ; 126 ( 2 ): 478 - 86 . doi: 10.1213/ANE.0000000000002098 http://dx.doi.org/10.1213/ANE.0000000000002098 .
Berger M , Nadler JW , Browndyke J , et al . Postoperative cognitive dysfunction: minding the gaps in our knowledge of a common postoperative complication in the elderly . Anesthesiol Clin 2015 ; 33 ( 3 ): 517 - 50 . doi: 10.1016/j.anclin.2015.05.008 http://dx.doi.org/10.1016/j.anclin.2015.05.008 .
Yi J , Xiang Z , Deng X , et al . Incidence of inadvertent intraoperative hypothermia and its risk factors in patients undergoing general anesthesia in Beijing: a prospective regional survey . PLoS One 2015 ; 10 ( 9 ): e0136136 . doi: 10.1371/journal.pone.0136136 http://dx.doi.org/10.1371/journal.pone.0136136 .
Horosz B , Malec-Milewska M . Inadvertent intraoperative hypothermia . Anaesthesiol Intensive Ther 2013 ; 45 ( 1 ): 38 - 43 . doi: 10.5603/AIT.2013.0009 http://dx.doi.org/10.5603/AIT.2013.0009 .
Bindu B , Bindra A , Rath G . Temperature management under general anesthesia: compulsion or option . J Anaesthesiol Clin Pharmacol 2017 ; 33 ( 3 ): 306 - 16 . doi: 10.4103/joacp.JOACP_334_16 http://dx.doi.org/10.4103/joacp.JOACP_334_16 .
Putzu M , Casati A , Berti M , et al . Clinical complications, monitoring and management of perioperative mild hypothermia: anesthesiological features . Acta Biomed 2007 ; 78 ( 3 ): 163 - 9 .
Pei L , Huang Y , Mao G , et al . Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery . Anesth Analg 2018 ; 126 ( 3 ): 833 - 38 . doi: 10.1213/ANE.0000000000002706 http://dx.doi.org/10.1213/ANE.0000000000002706 .
Dindo D , Demartines N , Clavien PA . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey . Ann Surg 2004 ; 240 ( 2 ): 205 - 13 . doi: 10.1097/01.sla.0000133083.54934.ae http://dx.doi.org/10.1097/01.sla.0000133083.54934.ae .
Akers JL , Dupnick AC , Hillman EL , et al . Inadvertent perioperative hypothermia risks and postoperative complications: a retrospective study . AORN J 2019 ; 109 ( 6 ): 741 - 7 . doi: 10.1002/aorn.12696 http://dx.doi.org/10.1002/aorn.12696 .
Insler SR , O'Connor MS , Leventhal MJ , et al . Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery . Ann Thorac Surg 2000 ; 70 ( 1 ): 175 - 81 . doi: 10.1016/s0003-4975(00)01415-6 http://dx.doi.org/10.1016/s0003-4975(00)01415-6 .
Moslemi-Kebria M , El-Nashar SA , Aletti GD , et al . Intraoperative hypothermia during cytoreductive surgery for ovarian cancer and perioperative morbidity . Obstet Gynecol 2012 ; 119 ( 3 ): 590 - 6 . doi: 10.1097/AOG.0b013e3182475f8a http://dx.doi.org/10.1097/AOG.0b013e3182475f8a .
Long KC , Tanner EJ , Frey M , et al . Intraoperative hypothermia during primary surgical cytoreduction for advanced ovarian cancer: risk factors and associations with postoperative morbidity . Gynecol Oncol 2013 ; 131 ( 3 ): 525 - 30 . doi: 10.1016/j.ygyno.2013.08.034 http://dx.doi.org/10.1016/j.ygyno.2013.08.034 .
Yi J , Lei Y , Xu S , et al . Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: national study in China . PLoS One 2017 ; 12 ( 6 ): e0177221 . doi: 10.1371/journal.pone.0177221 http://dx.doi.org/10.1371/journal.pone.0177221 .
Forbes SS , Stephen WJ , Harper WL , et al . Implementation of evidence-based practices for surgical site infection prophylaxis: results of a pre- and postintervention study . J Am Coll Surg 2008 ; 207 ( 3 ): 336 - 41 . doi: 10.1016/j.jamcollsurg.2008.03.014 http://dx.doi.org/10.1016/j.jamcollsurg.2008.03.014 .
Forbes SS , Eskicioglu C , Nathens AB , et al . Best practice in general surgery committee, university of Toronto . Evidence-based guidelines for prevention of perioperative hypothermia. J Am Coll Surg 2009 ; 209 ( 4 ): 492 - 503.e1 . doi: 10.1016/j.jamcollsurg.2009.07.002 http://dx.doi.org/10.1016/j.jamcollsurg.2009.07.002 .
Sessler DI , Pei L , Li K , et al . Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority trial . Lancet 2022 ; 399 ( 10337 ): 1799 - 808 . doi: 10.1016/S0140-6736(22)00560-8 http://dx.doi.org/10.1016/S0140-6736(22)00560-8 .
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