骨科手术后低体温的发生率及危险因素。
Incidence and Risk Factors for Postoperative Hypothermia After Orthopaedic Surgery.
机构信息
From the Department of Orthopaedic Surgery (Dr. Kleimeyer, Dr. Maloney, and Dr. Bishop), and the Department of Anesthesiology (Dr. Kadry), Stanford University School of Medicine, Stanford, CA, and Center for Innovation to Implementation, VA Palo Alto Health Care System, Livermore, CA (Dr. Harris), and the Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR (Dr. Sanford).
出版信息
J Am Acad Orthop Surg. 2018 Dec 15;26(24):e497-e503. doi: 10.5435/JAAOS-D-16-00742.
INTRODUCTION
Postoperative hypothermia is a common complication of orthopaedic surgery associated with increased morbidity. We identified the incidence and risk factors for postoperative hypothermia across orthopaedic surgical procedures.
METHODS
A total of 3,822 procedures were reviewed. Hypothermia was defined as temperature <36.0°C. Incidences were calculated and associated risk factors were evaluated by mixed-effects regression analyses.
RESULTS
Hypothermia was observed in 72.5% of patients intraoperatively and 8.3% postoperatively. Risk factors for postoperative hypothermia included intraoperative hypothermia (odds ratio [OR], 2.72), lower preoperative temperature (OR, 1.46), female sex (OR, 1.42), lower body mass index (OR, 1.06 per kg/m), older age (OR, 1.02 per year), adult reconstruction by specialty (OR, 4.06), and hip and pelvis procedures by anatomic region (OR, 8.76).
DISCUSSION
Intraoperative and postoperative hypothermia are common in patients who have undergone orthopaedic surgery. The high-risk groups identified in this study warrant increased attention and should be targets for interventions to prevent hypothermia and limit morbidity.
LEVEL OF EVIDENCE
Level IV, prognostic study.
简介
术后低体温是骨科手术常见的并发症，与发病率增加有关。我们确定了骨科手术中术后低体温的发生率和危险因素。
方法
共回顾了 3822 例手术。低体温定义为体温<36.0°C。通过混合效应回归分析计算发生率，并评估相关危险因素。
结果
术中低体温发生率为 72.5%，术后低体温发生率为 8.3%。术后低体温的危险因素包括术中低体温（OR，2.72）、术前体温较低（OR，1.46）、女性（OR，1.42）、较低的身体质量指数（OR，每 kg/m 增加 1.06）、年龄较大（OR，每年增加 1.02）、专科成人重建（OR，4.06）和解剖区域的髋关节和骨盆手术（OR，8.76）。
讨论
骨科手术后患者术中及术后低体温很常见。本研究确定的高危人群需要引起更多关注，应成为预防低体温和限制发病率的干预措施的目标。
证据等级
IV 级，预后研究。
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