髋/膝关节置换术患者术中低体温的患病率及危险因素：一项系统评价和荟萃分析
The prevalence and risk factors of intraoperative hypothermia in patients with hip/knee arthroplasty: a systematic review and meta-analysis.
作者信息
Fan Bingxin, Li Boliang, Wang Zhi, Wu Hao, Huang Li, Liu Surong
机构信息
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, China.
出版信息
BMC Musculoskelet Disord. 2025 Jul 28;26(1):722. doi: 10.1186/s12891-025-08962-9.
BACKGROUND
Intraoperative hypothermia (IOH) is common among patients undergoing total joint arthroplasty (TJA) of the lower extremities. Evaluating the risk factors for IOH is critical for the success of preventive interventions. This study aims to systematically assess the prevalence and risk factors of IOH in TJA patients.
DESIGN
Systematic review and meta-analysis.
METHODS
Two independent researchers conducted a literature search across eight databases: PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, WANFANG Data, and CBM. The quality of included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model was employed to analyze the prevalence and risk factors of IOH. All analyses were performed using Stata 12.0 software.
RESULTS
Across 21 cohort studies on TJA patients, the pooled prevalence of IOH was 35.28% (95% CI: 27.50%-43.48%). Subgroup analysis revealed an IOH prevalence of 38.66% (95% CI: 28.67%-49.16%) in THA patients and 27.23% (95% CI: 18.37%- 37.11%) in TKA patients. Significant risk factors for IOH included intraoperative blood loss, intraoperative infusion volume, operating room temperature, and surgical time. Current evidence does not support a clear association between patient age, anesthesia time, and IOH.
CONCLUSION
Our Meta-analysis indicates that the prevalence of IOH is high among TJA patients, despite significant heterogeneity (I² =98.7%, τ²= 0.15), the pooled analysis suggested the prevalence of IOH in TJA patients was 35.28% (95% CI: 27.50%-43.48%). However, the interpretation of these findings should be cautious due to substantial variability across studies. Additionally, assessment of intraoperative blood loss, infusion volume, operating room temperature, and surgical time should be integral to IOH risk evaluation in TJA patients. Future studies are needed to further explore the roles of age and anesthesia time as potential risk factors. Tailored IOH prevention strategies should be developed by addressing modifiable risk factors.
TRIAL REGISTRATION
PROSPERO Registration ID: CRD42024559846
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12891-025-08962-9.
背景
术中低体温（IOH）在接受下肢全关节置换术（TJA）的患者中很常见。评估IOH的危险因素对于预防性干预措施的成功至关重要。本研究旨在系统评估TJA患者中IOH的患病率及危险因素。
设计
系统评价与荟萃分析。
方法
两名独立研究人员在八个数据库中进行文献检索：PubMed、科学网、Embase、Cochrane图书馆、中国知网、维普资讯、万方数据和中国生物医学文献数据库。采用纽卡斯尔-渥太华量表评估纳入研究的质量。采用随机效应模型分析IOH的患病率及危险因素。所有分析均使用Stata 12.0软件进行。
结果
在21项关于TJA患者的队列研究中，IOH的合并患病率为35.28%（95%CI：27.50%-43.48%）。亚组分析显示，全髋关节置换术（THA）患者中IOH的患病率为38.66%（95%CI：28.67%-49.16%），全膝关节置换术（TKA）患者中为27.23%（95%CI：18.37%-37.11%）。IOH的显著危险因素包括术中失血量、术中输液量、手术室温度和手术时间。目前的证据不支持患者年龄、麻醉时间与IOH之间存在明确关联。
结论
我们的荟萃分析表明，尽管存在显著异质性（I²=98.7%，τ²=0.15），但TJA患者中IOH的患病率较高，合并分析显示TJA患者中IOH的患病率为35.28%（95%CI：27.50%-43.48%）。然而，由于各研究之间存在较大差异，对这些结果的解释应谨慎。此外，评估术中失血量、输液量、手术室温度和手术时间应成为TJA患者IOH风险评估的组成部分。未来需要进一步研究以探讨年龄和麻醉时间作为潜在危险因素的作用。应通过解决可改变的危险因素来制定针对性的IOH预防策略。
试验注册
PROSPERO注册号：CRD42024559846
补充信息
在线版本包含可在10.1186/s12891-025-08962-9获取的补充材料。
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