Intraoperative Hypothermia and Surgical Site Infection After Major Abdominal Surgery: A Prospective Cohort Study

Ramesh S K; Varshini J

doi:10.37022/wjcmpr.v8i3.456

Authors

Ramesh S. K Assistant Professor, Department of General Surgery, Oxford Medical College and Hospital, Bangalore, Karnataka, India.
Varshini J. Assistant Professor, Department of Pulmonary Medicine, Rajiv Gandhi Institute of Chest Disease (SDS TRC & RGICD), Bangalore, Karnataka, India.

Abstract

Background: Inadvertent perioperative hypothermia is common during major abdominal surgery and may adversely affect tissue perfusion, immune function and wound healing. Surgical site infection (SSI) remains an important postoperative complication and may prolong hospital stay and increase healthcare utilization.

Objective: To evaluate the association between intraoperative hypothermia and the development of SSI following major abdominal surgery and to identify other perioperative factors associated with postoperative infection.

Methods: This prospective cohort study included 286 adult patients undergoing major abdominal surgery under general anaesthesia. Core temperature was recorded before induction and at 30-minute intervals intraoperatively. Patients were classified according to whether their intraoperative core temperature fell below 36.0°C. Patients were followed prospectively for 30 days after surgery for development of SSI. Demographic, clinical, operative and postoperative variables were recorded. Multivariable logistic regression was performed to identify factors independently associated with SSI.

Results: In the analysis, 143 patients (50.0%) experienced intraoperative hypothermia, while 143 (50.0%) remained normothermic. SSI developed in 34 patients (11.9%). The incidence of SSI was higher among patients with hypothermia than among normothermic patients (17.5% vs. 6.3%, p=0.006). Hypothermic patients had longer mean hospital stays (11.2±3.2 vs. 9.3±3.4 days, p<0.001). On multivariable analysis, hypothermia was not independently associated with SSI (adjusted OR 2.44, 95% CI 0.82–7.28; p=0.109), whereas diabetes mellitus, contaminated/dirty wound classification, and blood transfusion remained independently associated with SSI.

Conclusion: In this cohort, intraoperative hypothermia was associated with a higher incidence of SSI in unadjusted analysis, but the association was not statistically significant after multivariable adjustment. Routine temperature monitoring and active warming remain relevant perioperative considerations.

Keywords:

Intraoperative hypothermia, surgical site infection, abdominal surgery, perioperative temperature, normothermia, wound infection

DOI

https://doi.org/10.37022/wjcmpr.v8i3.456

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