Huang Xiaohui, Ren Mobai, Pan Junrong, Huang Ene, Li Yanhong, Guo Donghao, Wang Junjie
Department of Operating Room, Quanzhou Women's and Children's Hospital, Quanzhou, China.
School of Clinical Medicine, Shanghai Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ann Med. 2025 Dec;57(1):2540019. doi: 10.1080/07853890.2025.2540019. Epub 2025 Jul 30.
BACKGROUND: Intraoperative hypothermia is a significant life-threatening emergency during surgery in patients with Hirschsprung's disease (HSCR). The aim of this study is to explore the risk factors and predictors of intraoperative hypothermia in HSCR patients. METHODS: This cohort comprised 85 patients with HSCR who underwent surgery at Quanzhou Children's Hospital and the patients were divided into the intraoperative non-hypothermia group and the intraoperative hypothermia group. The study compared the characteristics of two groups and used univariate and multiple logistic regression analyses to assess the potential risk factors for intraoperative hypothermia. Models were adjusted for covariates, and interaction terms were evaluated for albumin (ALB) and intraoperative hypothermia. Subgroup analysis included stratification by sex and age. ROC analysis was applied to determine the optimal threshold for ALB. RESULTS: In this retrospective study, 71 patients had intraoperative non-hypothermia and 14 patients had intraoperative hypothermia (83.5% versus 16.5%). Comparing the clinical characteristics between two groups, baseline core temperature, ALB and alkaline phosphatase ( < .001, = .001 and = .036, respectively) showed significant differences. Univariate logistic regression showed that baseline core temperature (OR = 0.001, 95%CI = 0.000-0.024, < .001), ALB (OR = 0.820, 95%CI = 0.679-0.972, = .028) and gamma-glutamyl transferase (OR = 1.017, 95%CI = 1.001-1.035, = .043) had significant associations with intraoperative hypothermia. Multiple logistic regression showed that both ALB (OR = 0.782, 95%CI = 0.611-0.965, = .031) and baseline core temperature (OR = 0.001, 95%CI = 0.000-0.019, < .001) were negatively associated with intraoperative hypothermia. The relationship between ALB and intraoperative hypothermia remained significant after adjusting for covariates. ROC analysis identified 41.45 g/L as the optimal threshold of ALB for predicting intraoperative hypothermia, with a sensitivity of 85.71% and a specificity of 64.79%. CONCLUSION: ALB is an independent risk factor for intraoperative hypothermia in HSCR patients. Further investments are required to explore its mechanisms.
背景：术中低体温是先天性巨结肠症（HSCR）患者手术期间严重的危及生命的紧急情况。本研究旨在探讨HSCR患者术中低体温的危险因素和预测因素。 方法：该队列包括85例在泉州市儿童医院接受手术的HSCR患者，将患者分为术中非低体温组和术中低体温组。本研究比较了两组的特征，并使用单因素和多因素逻辑回归分析来评估术中低体温的潜在危险因素。对模型进行协变量调整，并评估白蛋白（ALB）与术中低体温的交互项。亚组分析包括按性别和年龄分层。应用ROC分析确定ALB的最佳阈值。 结果：在这项回顾性研究中，71例患者术中未发生低体温，14例患者术中发生低体温（83.5%对16.5%）。比较两组的临床特征，基线核心体温、ALB和碱性磷酸酶（分别为<.001、=.001和=.036）显示出显著差异。单因素逻辑回归显示，基线核心体温（OR = 0.001，95%CI = 0.000 - 0.024，<.001）、ALB（OR = 0.820，95%CI = 0.679 - 0.972，=.028）和γ-谷氨酰转移酶（OR = 1.017，95%CI = 1.001 - 1.035，=.043）与术中低体温有显著关联。多因素逻辑回归显示，ALB（OR = 0.782，95%CI = 0.611 - 0.965，=.031）和基线核心体温（OR = 0.001，95%CI = 0.000 - 0.019，<.001）均与术中低体温呈负相关。调整协变量后，ALB与术中低体温之间的关系仍然显著。ROC分析确定41.45 g/L为预测术中低体温的ALB最佳阈值，敏感性为85.71%，特异性为64.79%。 结论：ALB是HSCR患者术中低体温的独立危险因素。需要进一步研究以探索其机制。
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