Division of Pediatric Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California.
Division of Pediatric Surgery, Children's Hospital and Medical Center, Omaha, Nebraska; Division of General Surgery, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
J Surg Res. 2022 Aug;276:235-241. doi: 10.1016/j.jss.2022.02.054. Epub 2022 Apr 5.
Unintended perioperative hypothermia is associated with surgical site infection (SSI) in adults, prompting exhaustive efforts to maintain perioperative normothermia. Although these efforts are also made for pediatric patients, the association between hypothermia and SSI has not been demonstrated in children. We sought to determine whether perioperative hypothermia and other risk factors and clinical outcomes are associated with SSI in the pediatric population.
This case-control study took place from January 2014 through December 2016 and included patients at a National Surgical Quality Improvement Program-participant academic children's hospital. All surgical patients were included in this retrospective analysis. SSI rates were determined. A univariate analysis was performed to determine clinical factors associated with SSI. A multivariate regression analysis was then performed to determine the predictive effect of minimum perioperative temperature for SSI.
This study included 3541 patients, of which 92 (2.6%) developed SSI. A univariate analysis showed associations among SSI and higher perioperative temperatures, surgical specialty of otolaryngology and general surgery, and wound classification (American Society of Anesthesiologists [ASA] classification III and IV). A multivariate analysis determined the odds of SSI increased by a factor of 1.6 for every 1°C increase in minimum perioperative temperature.
Unintended perioperative hypothermia in our pediatric patients was inversely associated with SSI. This finding suggests that pediatric SSI prevention may not require the efforts made for adult patients to maintain normothermia.
围手术期意外低体温与成人手术部位感染（SSI）有关，这促使人们全力以赴维持围手术期正常体温。尽管这些努力也针对儿科患者，但低体温与 SSI 之间的关联尚未在儿童中得到证实。我们试图确定围手术期低体温和其他危险因素以及临床结果是否与儿科人群的 SSI 相关。
这项病例对照研究于 2014 年 1 月至 2016 年 12 月进行，包括一家参加国家手术质量改进计划的学术儿童医院的患者。所有手术患者均纳入本回顾性分析。确定 SSI 发生率。进行单因素分析以确定与 SSI 相关的临床因素。然后进行多变量回归分析，以确定围手术期最低温度对 SSI 的预测效果。
这项研究包括 3541 名患者，其中 92 名（2.6%）发生 SSI。单因素分析显示，SSI 与较高的围手术期体温、耳鼻喉科和普通外科手术专业以及伤口分类（美国麻醉师协会[ASA]分类 III 和 IV）之间存在关联。多变量分析确定，围手术期最低温度每升高 1°C，SSI 的发生几率增加 1.6 倍。
我们的儿科患者围手术期意外低体温与 SSI 呈负相关。这一发现表明，儿科 SSI 的预防可能不需要成人患者为维持正常体温所做的努力。
