The impact of intraoperative hypothermia on early postoperative adverse events after radical esophagectomy for cancer: a retrospective cohort study.

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.