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Postoperative hypothermia following non-cardiac high-risk surgery: A prospective study of temporal patterns and risk factors.
Sabbag, Itajiba Paternosti; Hohmann, Fabio Barlem; Assunção, Murillo Santucci Cesar; de Freitas Chaves, Renato Carneiro; Corrêa, Thiago Domingos; Menezes, Pedro Ferro L; Neto, Ary Serpa; Sá Malbouisson, Luiz Marcelo; Lobo, Suzana Margareth Ajeje; Amendola, Cristina Prata; de Aguilar-Nascimento, Jose Eduardo; Silva, João Manoel.
Afiliação
  • Sabbag IP; Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Hohmann FB; Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Assunção MSC; Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • de Freitas Chaves RC; Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Corrêa TD; Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Menezes PFL; Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Neto AS; Departamento de Pacientes Graves, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Sá Malbouisson LM; Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Lobo SMA; Unidade de Terapia Intensiva, Hospital de Base, Medical School of São José do Rio Preto, São José do Rio Preto, SP, Brazil.
  • Amendola CP; Unidade de Terapia Intensiva, Hospital de Câncer de Barretos, Pio XII Foundation, Barretos, SP, Brazil.
  • de Aguilar-Nascimento JE; Unidade de Terapia Intensiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil.
  • Silva JM; Hospital das Clínicas, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
PLoS One ; 16(11): e0259789, 2021.
Article em En | MEDLINE | ID: mdl-34780517
BACKGROUND AND OBJECTIVES: Hypothermia occurs commonly during surgery and can cause postoperative complications. We aimed to describe the characteristics and outcomes of hypothermia in patients undergoing major surgeries. METHODS: This prospective, observational, multicenter study of a nationally representative sample included all patients over 18 years of age admitted to an intensive care unit (ICU). Thirty ICUs were selected randomly at national level. The main outcome measure was the proportion of patients who developed postoperative hypothermia in the first 24 hours of ICU admission. Patients were divided into three groups based on temperature: <35°C, <36°C, and ≥36°C (no hypothermia). Patients' characteristics, postoperative complications, and risk factors were evaluated in all groups. To verify whether hypothermia was a strong risk factor for postoperative complications, a Kaplan-Meier curve was generated and adjusted using a Cox regression model. RESULTS: In total, 738 patients had their temperatures measured. The percentage of patients with temperature <35°C (median [Q1-Q3], 34.7°C [34.3-34.9°C]) was 19.1% (95% confidence interval [CI] = 16.1-22.5) and that of patients with temperature <36°C (median [Q1-Q3], 35.4°C [35.0-35.8°C]) was 64% (95% CI = 58.3-70.0). The percentage of surgical complications was 38.9%. Patients with hypothermia were older, had undergone abdominal surgeries, had undergone procedures of longer duration, and had more comorbidities. A postoperative temperature ≤35°C was an independent risk for composite postoperative complications (hazard ratio = 1.523, 95% CI = 1.15-2.0), especially coagulation and infection. CONCLUSIONS: Inadvertent hypothermia was frequent among patients admitted to the ICU and occurred more likely after abdominal surgery, after a long procedure, in elderly patients, and in patients with a higher number of comorbidities. Low postoperative temperature was associated with postoperative complications.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipotermia Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Humans / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipotermia Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Humans / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos