Inadvertent perioperative hypothermia and surgical site infections after liver resection  

作　　者：Yi-De Zhou Wen-Yuan Zhang Guo-Hao Xie Hui Ye Li-Hua Chu Yu-Qian Guo Yi Lou Xiang-Ming Fang 

机构地区：[1]Department of Anesthesiology and Intensive Care Medicine,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》2024年第6期579-585,共7页国际肝胆胰疾病杂志（英文版）

基　　金：supported by grants from the Key R&D Program of Zhejiang(2022C03163);the National Natural Science Foundation of China(82072148).

摘　　要：Background:In the overall surgical population,inadvertent perioperative hypothermia has been associated with an increased incidence of surgical site infection(SSI).However,recent clinical trials did not validate this notion.This study aimed to investigate the potential correlation between inadvertent perioperative hypothermia and SSIs following liver resection.Methods:This retrospective cohort study included all consecutive patients who underwent liver resection between January 2019 and December 2021 at the First Affiliated Hospital,Zhejiang University School of Medicine.Perioperative temperature managements were implemented for all patients included in the analysis.Estimated propensity score matching(PSM)was performed to reduce the baseline imbalances between the normothermia and hypothermia groups.Before and after PSM,univariate analyses were performed to evaluate the correlation between hypothermia and SSI.Multivariate regression analysis was performed to determine whether hypothermia was an independent risk factor for postoperative transfusion and major complications.Subgroup analyses were performed for diabetes mellitus,age>65 years,and major liver resection.Results:Among 4000 patients,2206 had hypothermia(55.2%),of which 150 developed SSI(6.8%).PSM yielded 1434 individuals in each group.After PSM,the hypothermia and normothermia groups demonstrated similar incidence rates of SSI(7.0%vs.6.3%,P=0.453),postoperative transfusion(13.7%vs.13.3%,P=0.743),and major complications(10.1%vs.9.0%,P=0.309).Univariate regression analysis revealed no significant effects of hypothermia on the incidence of SSI in the group with the highest hypothermia exposure[odds ratio(OR)=1.25,95%confidence interval(CI):0.84-1.87,P=0.266],the group with moderate exposure(OR=1.00,95%CI:0.65-1.53,P=0.999),or the group with the lowest exposure(OR=1.11,95%CI:0.73-1.65,P=0.628).The subgroup analysis revealed similar results.Regarding liver function,patients in the hypothermia group demonstrated lowerγ-glutamyl transpeptidase(37 vs.43 U/L,P<0.

关 键 词：Surgical site infection Perioperative hypothermia Liver resection Postoperative complications Intraoperative care 

分 类 号：R657.3[医药卫生—外科学]