Inadvertent perioperative hypothermia and surgical site infections after liver resection

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外文标题：Inadvertent perioperative hypothermia and surgical site infections after liver resection

外文摘要：Background:In the overall surgical population,inadvertent perioperative hypothermia has been associ-ated 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 peri-operative hypothermia and SSIs following liver resection.Methods:This retrospective cohort study included all consecutive patients who underwent liver resec-tion 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 per-formed to evaluate the correlation between hypothermia and SSI.Multivariate regression analysis was performed to determine whether hypothermia was an independent risk factor for postoperative transfu-sion 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 demon-strated 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 hypother-mia 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％Cl:0.73-1.65,P=0.628).The subgroup analysis revealed similar results.Regarding liver function,patients in the hypothermia group demonstrated lower y-glutamyl transpeptidase(37 vs.43 U/L,P＜0.001)and alkaline phosphatase(69 vs.72 U/L,P=0.016).However,patients in the hypother-mia group exhibited prolonged activated partial thromboplastin time(29.2 vs.28.6 s,P＜0.001).Conclusions:In our study of patients undergoing liver resection,we found no significant association be-tween mild perioperative hypothermia and SSI.It might be due to the perioperative temperature man-agements,especially active warming measures,which limited the impact of perioperative hypothermia on the occurrence of SSI.

作者：

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

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作者单位：

Department of Anesthesiology and Intensive Care Medicine,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China

关键词：

Surgical site infection Perioperative hypothermia Liver resection Postoperative complications Intraoperative care

出版年：

2024

DOI：

10.1016/j.hbpd.2023.12.006

国际肝胆胰疾病杂志(英文版)

影响因子：0.668

ISSN：1499-3872

年,卷(期)：2024.23(6)

Yi-De Zhou,Wen-Yuan Zhang,Guo-Hao Xie,等.Inadvertent perioperative hypothermia and surgical site infections after liver resection[J].国际肝胆胰疾病杂志(英文版),2024,23(6):579-585.DOI:10.1016/j.hbpd.2023.12.006.