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腹部大手术患者术后低体温暴露及其与并发症的关系：一项回顾性队列研究
贵州医科大学 麻醉与心脏电生理课题组
翻译：王贵龙 编辑：赵游霄 审校：曹莹
背景：
围手术期许多接受腹部大手术的患者会出现未预料的体温过低。本研究旨在确定与术后低体温相关的危险因素及其与术后并发症的关系。
方法：
这项回顾性队列研究提取了2018年1月1日至2022年12月31日期间韩国三级大学医学中心首尔国立大学医院的数据库，纳入年龄≥18岁、接受择期腹部大手术且超过2小时的患者，患者分为低体温组（体温<36.5℃）和非低体温组（体温≥36.5℃）。
结果：
研究纳入30194名患者，其中21293名和8901名患者分别为低体温组和非低体温组。与术后低温发生相关的因素包括手术类型等。在多变量逻辑回归模型中，低体温组术后并发症的发生率比非低体温组高9%（OR：1.09；95%CI：1.01-1.19；P=0.040）。在术后并发症中，低体温组急性肾损伤的发生率比非低体温组高14%（OR：1.14；95%CI，1.04-1.25；P=0.007）。
结论：
在麻醉恢复期的前30分钟出现术后低体温与术后并发症的出现显著相关，尤其是急性肾损伤。但仍需要进一步的研究来验证这一发现。
原始文献：
Saeyeon, Kim; In-Ae, Song; Tak Kyu, Oh；Exposure to postoperative hypothermia and its association with complications after major abdominal surgery: a retrospective cohort study；Ann Surg Treat Res 2024 Aug;107(2):120-126；DOI：10.4174/astr.2024.107.2.120；PMID：39139831
英文原文：
Exposure to postoperative hypothermia and its association with complications after major abdominal surgery: a retrospective cohort study
PURPOSE: Many patients who undergo major abdominal surgery experience inadvertent hypothermia during the perioperative period. This study aimed to identify risk factors related to postoperative hypothermia and their association with postoperative complications.
METHODS: This retrospective cohort study used data from Seoul National University Bundang Hospital, a tertiary university medical center in South Korea, between January 1, 2018 and December 31, 2022. We included patients aged ≥18 years who underwent elective major abdominal surgery for more than 2 hours in the operating room. The patients were categorized into the hypothermia (body temperature <36.5℃) and non-hypothermia (body temperature ≥36.5℃) groups.
RESULTS: The study sample comprised 30,194 patients, and we classified 21,293 and 8,901 into the hypothermic and non-hypothermic groups, respectively. Some factors associated with the occurrence of postoperative hypothermia included the type of surgery. In the multivariable logistic regression model, the incidence of postoperative complications was 9% higher in the hypothermia group than in the non-hypothermic group (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01-1.19; P = 0.040). Among postoperative complications, the hypothermic group showed a 14% higher incidence of acute kidney injury (OR, 1.14; 95% CI, 1.04-1.25; P = 0.007) than the non-hypothermic group.
CONCLUSION: The appearance of postoperative hypothermia during the first 30 minutes of the recovery period was significantly associated with the appearance of postoperative complications, especially acute kidney injury. However, further studies are required to validate these findings.
