BACKGROUND Maintaining perioperative normothermia is recommended by recent guidelines for the prevention of surgical site infections (SSIs). However, the majority of supporting data originates outside the field of orthopaedic surgery. METHODS The effect of normothermia was explored using the prospectively collected data of consecutive patients who underwent single-site surgery in 7 tertiary referral hospitals between November 2013 and July 2016. SSIs, urinary tract infections (UTIs), respiratory tract infections (RTIs), cardiac and cerebral events (CCE), and all-cause mortality rates within 30 days after surgery were compared between patients with normothermia (body temperature ≥36°C) and those with hypothermia (<36°C) at the end of surgery, after closure. Multivariable adjusted and inverse-probability weighted regression analyses were performed. RESULTS The final cohort included 8841 patients. Of these, 11.4% (n = 1008) were hypothermic. More than 96% were evaluated in person by the physicians. After adjusting for multiple covariates, normothermia was not significantly associated with SSIs (adjusted odds ratio [aOR] 1.18, 95% confidence interval [CI] 0.59-2.33), UTIs (aOR 1.14, 95% CI 0.66-1.95), RTIs (aOR 0.60, 95% CI 0.31-1.19), or CCE (aOR 0.53, 95% CI 0.26-1.09). In contrast, normothermia was associated with a lower risk of 30-day mortality (aOR 0.26, 95% CI 0.11-0.64; P < .01; weighted hazard ratio 0.21, 95% CI 0.07-0.68; P = .002). In a subgroup analysis, normothermia was associated with reduced mortality in all types of surgical procedures. CONCLUSIONS Whereas our findings suggest no clear association with SSI risks following orthopedic surgery, our study supports maintaining perioperative normothermia, as it is associated with reduced 30-day mortality.

中文翻译：

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手术结束后的正常体温与骨科手术后的术后并发症之间的关联。

背景技术为防止手术部位感染（SSI）的最新指南推荐维持围手术期的体温正常。但是，大多数支持数据都来自骨科手术领域。方法使用前瞻性收集的2013年11月至2016年7月在7家三级转诊医院接受单点手术的连续患者的数据探讨常温的影响。SSI，尿路感染（UTI），呼吸道感染（RTIs），心脏比较了正常体温（体温≥36°C）和体温过低（<36°C）患者在手术结束后，封闭后的术后30天内的脑卒中，脑事件（CCE）和全因死亡率。进行了多变量调整和逆概率加权回归分析。结果最后的队列包括8841例患者。其中11.4％（n = 1008）为低温。超过96％的医生亲自进行了评估。在对多个协变量进行调整后，正常体温与SSI（调整后的优势比[aOR] 1.18、95％置信区间[CI] 0.59-2.33），UTIs（aOR 1.14、95％CI 0.66-1.95），RTIs（aOR）没有显着相关性0.60，95％CI 0.31-1.19）或CCE（aOR 0.53，95％CI 0.26-1.09）。相反，常温与较低的30天死亡率风险相关（aOR 0.26，95％CI 0.11-0.64； P <.01；加权危险比0.21，95％CI 0.07-0.68； P = .002）。在亚组分析中，在所有类型的外科手术中，正常体温与死亡率降低相关。