Chen Ruirong, Du Yingjie, Chen Lanyue, Bai Yafan, Zhang Yue, Yu Tiankuo, Li He, Wang Guyan
Department of Anaesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
BMC Anesthesiol. 2025 Sep 2;25(1):443. doi: 10.1186/s12871-025-03277-7.
The connection between perioperative hypothermia and the occurrence of surgical site infections (SSIs) is still not clearly established. This investigation aimed to clarify the potential link between these two factors using meta-analytical techniques.
This investigation examined the potential connection of perioperative hypothermia to the risk of SSI. A comprehensive literature review was conducted utilizing PubMed, Web of Science, and Embase. The primary endpoint was the incidence of SSI. Pooled risk ratios were estimated using fixed- or random-effects meta-analysis. Sensitivity analyses were performed to evaluate the impact of preoperative hypothermia on the pooled risk of SSI. Statistical analyses were performed using Review Manager software and R software.
Our meta-analysis encompassed 25 studies representing a total of 28,761 patients. The analysis revealed no statistically significant association between patients' intraoperative body temperature and their likelihood of developing post-surgical complications [odds ratio (OR), 1.39; 95% confidence interval (CI), 0.98-1.96; I = 89%, P = 0.06]. However, two notable exceptions emerged from the subgroup analyses. Most importantly, patients undergoing breast surgery demonstrated a significantly higher risk of SSI when experiencing intraoperative hypothermia, with an odds ratio of 1.97 (95% CI: 1.21-3.21, I = 0%, P < 0.01). Additionally, across all patient groups, a consistent trend was noted: when intraoperative body temperature fell to 35 °C or below, there was a substantial increase in SSI risk (OR: 2.12, 95% CI: 1.42-3.16, I = 89%, P < 0.01).
The findings suggest that the relationship between perioperative hypothermia and an increased incidence of SSI is not definitive; however, it is significantly associated with breast surgery and when body temperature falls below 35 °C. Future randomized controlled trials (RCTs) should focus on breast surgery and standardize temperature thresholds. Due to the high heterogeneity, the interpretation of this result should be approached with caution, and there is a call for future high-quality research.
围手术期体温过低与手术部位感染（SSIs）的发生之间的联系仍未明确确立。本研究旨在运用荟萃分析技术阐明这两个因素之间的潜在联系。
本研究探讨围手术期体温过低与SSI风险的潜在关联。利用PubMed、科学网和Embase进行了全面的文献综述。主要终点是SSI的发生率。使用固定效应或随机效应荟萃分析估计合并风险比。进行敏感性分析以评估术前体温过低对SSI合并风险的影响。使用Review Manager软件和R软件进行统计分析。
我们的荟萃分析纳入了25项研究，共涉及28761例患者。分析显示患者术中体温与术后发生并发症的可能性之间无统计学显著关联[优势比（OR）为1.39；95%置信区间（CI）为0.98 - 1.96；I = 89%，P = 0.06]。然而，亚组分析出现了两个显著例外。最重要的是，接受乳房手术的患者在术中体温过低时发生SSI的风险显著更高，优势比为1.97（95% CI：1.21 - 3.21，I = 0%，P < 0.01）。此外，在所有患者组中都观察到一个一致的趋势：当术中体温降至35°C或更低时，SSI风险大幅增加（OR：2.12，95% CI：1.42 - 3.16，I = 89%，P < 0.01）。
研究结果表明围手术期体温过低与SSI发生率增加之间的关系并不确定；然而，它与乳房手术以及体温降至35°C以下显著相关。未来的随机对照试验（RCT）应聚焦于乳房手术并规范体温阈值。由于异质性较高，对该结果的解释应谨慎，并且需要未来的高质量研究。
