Journal of cardiothoracic and vascular anesthesia · 2014
The impact of intraoperative hypothermia on early postoperative adverse events after radical esophagectomy for cancer: a retrospective cohort study.
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Yamasaki Hiroyuki, Tanaka Katsuaki, Funai Yusuke, Suehiro Koichi, Ikenaga Kazutake, Mori Takashi, Osugi Harushi, Nishikawa Kiyonobu
Аннотация
OBJECTIVE: To investigate the correlation between intraoperative body temperature and postoperative adverse effects in patients who underwent esophagectomy procedures.
DESIGN: Retrospective cohort study.
SETTING: University Hospital.
PARTICIPANTS: One hundred twenty-one patients undergoing esophagectomy were enrolled.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Various perioperative and intraoperative variables were recorded. Hypothermia was defined as a urinary bladder temperature<35°C. Multiple logistic regression analysis was conducted to identify independent significant predictors of postoperative complications. In addition, the authors also determined a cutoff point for intraoperative minimum urinary bladder temperature by analyzing receiver operating characteristic (ROC) curves for occurrence of adverse events at 1 month after surgery. No patients died within 1 month after the surgery. There were 53 patients with early postoperative complications, and 51 had experienced intraoperative hypothermia. Factors that were correlated significantly with complications included age (p=0.02); hypothermia (p<0.01); and doses of ephedrine (p<0.01), phenylephrine (p<0.01), and fentanyl (p<0.01). Multiple logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio 2.57; 95% confidence interval 1.09-6.08). The area under the ROC curve for body temperature was 0.71, and the cutoff point was 35°C (sensitivity=0.65, specificity=0.72).
CONCLUSIONS: Intraoperative hypothermia was identified as an independent risk factor for early postoperative adverse events following esophagectomy.
DESIGN: Retrospective cohort study.
SETTING: University Hospital.
PARTICIPANTS: One hundred twenty-one patients undergoing esophagectomy were enrolled.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Various perioperative and intraoperative variables were recorded. Hypothermia was defined as a urinary bladder temperature<35°C. Multiple logistic regression analysis was conducted to identify independent significant predictors of postoperative complications. In addition, the authors also determined a cutoff point for intraoperative minimum urinary bladder temperature by analyzing receiver operating characteristic (ROC) curves for occurrence of adverse events at 1 month after surgery. No patients died within 1 month after the surgery. There were 53 patients with early postoperative complications, and 51 had experienced intraoperative hypothermia. Factors that were correlated significantly with complications included age (p=0.02); hypothermia (p<0.01); and doses of ephedrine (p<0.01), phenylephrine (p<0.01), and fentanyl (p<0.01). Multiple logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio 2.57; 95% confidence interval 1.09-6.08). The area under the ROC curve for body temperature was 0.71, and the cutoff point was 35°C (sensitivity=0.65, specificity=0.72).
CONCLUSIONS: Intraoperative hypothermia was identified as an independent risk factor for early postoperative adverse events following esophagectomy.