TY - JOUR
T1 - Postoperative hypothermia following non-cardiac high-risk surgery
T2 - A prospective study of temporal patterns and risk factors
AU - Sabbag, Itajiba Paternosti
AU - Hohmann, Fabio Barlem
AU - Assunção, Murillo Santucci Cesar
AU - de Freitas Chaves, Renato Carneiro
AU - Corrêa, Thiago Domingos
AU - Menezes, Pedro Ferro L.
AU - Neto, Ary Serpa
AU - Malbouisson, Luiz Marcelo Sá
AU - Lobo, Suzana Margareth Ajeje
AU - Amendola, Cristina Prata
AU - de Aguilar-Nascimento, Jose Eduardo
AU - Silva, João Manoel
AU - on behalf of The BRASIS Study Group
N1 - Publisher Copyright:
© 2021 Sabbag et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/11/15
Y1 - 2021/11/15
N2 - Background and objectives Hypothermia occurs commonly during surgery and can cause postoperative complications. We aimed to describe the characteristics and outcomes of hypothermia in patients undergoing major surgeries. Methods This prospective, observational, multicenter study of a nationally representative sample included all patients over 18 years of age admitted to an intensive care unit (ICU). Thirty ICUs were selected randomly at national level. The main outcome measure was the proportion of patients who developed postoperative hypothermia in the first 24 hours of ICU admission. Patients were divided into three groups based on temperature: <35C, <36C, and >36C (no hypothermia). Patients’ characteristics, postoperative complications, and risk factors were evaluated in all groups. To verify whether hypothermia was a strong risk factor for postoperative complications, a Kaplan–Meier curve was generated and adjusted using a Cox regression model. Results In total, 738 patients had their temperatures measured. The percentage of patients with temperature <35C (median [Q1-Q3], 34.7C [34.3–34.9C]) was 19.1% (95% confidence interval [CI] = 16.1–22.5) and that of patients with temperature <36C (median [Q1-Q3], 35.4C [35.0–35.8C]) was 64% (95% CI = 58.3–70.0). The percentage of surgical complications was 38.9%. Patients with hypothermia were older, had undergone abdominal surgeries, had undergone procedures of longer duration, and had more comorbidities. A postoperative temperature <35C was an independent risk for composite postoperative complications (hazard ratio = 1.523, 95% CI = 1.15–2.0), especially coagulation and infection. Conclusions Inadvertent hypothermia was frequent among patients admitted to the ICU and occurred more likely after abdominal surgery, after a long procedure, in elderly patients, and in patients with a higher number of comorbidities. Low postoperative temperature was associated with postoperative complications.
AB - Background and objectives Hypothermia occurs commonly during surgery and can cause postoperative complications. We aimed to describe the characteristics and outcomes of hypothermia in patients undergoing major surgeries. Methods This prospective, observational, multicenter study of a nationally representative sample included all patients over 18 years of age admitted to an intensive care unit (ICU). Thirty ICUs were selected randomly at national level. The main outcome measure was the proportion of patients who developed postoperative hypothermia in the first 24 hours of ICU admission. Patients were divided into three groups based on temperature: <35C, <36C, and >36C (no hypothermia). Patients’ characteristics, postoperative complications, and risk factors were evaluated in all groups. To verify whether hypothermia was a strong risk factor for postoperative complications, a Kaplan–Meier curve was generated and adjusted using a Cox regression model. Results In total, 738 patients had their temperatures measured. The percentage of patients with temperature <35C (median [Q1-Q3], 34.7C [34.3–34.9C]) was 19.1% (95% confidence interval [CI] = 16.1–22.5) and that of patients with temperature <36C (median [Q1-Q3], 35.4C [35.0–35.8C]) was 64% (95% CI = 58.3–70.0). The percentage of surgical complications was 38.9%. Patients with hypothermia were older, had undergone abdominal surgeries, had undergone procedures of longer duration, and had more comorbidities. A postoperative temperature <35C was an independent risk for composite postoperative complications (hazard ratio = 1.523, 95% CI = 1.15–2.0), especially coagulation and infection. Conclusions Inadvertent hypothermia was frequent among patients admitted to the ICU and occurred more likely after abdominal surgery, after a long procedure, in elderly patients, and in patients with a higher number of comorbidities. Low postoperative temperature was associated with postoperative complications.
UR - http://www.scopus.com/inward/record.url?scp=85119251708&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0259789
DO - 10.1371/journal.pone.0259789
M3 - Article
C2 - 34780517
AN - SCOPUS:85119251708
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 11 November
M1 - e0259789
ER -