title: The impact of intraoperative hypothermia on early postoperative adverse events after radical esophagectomy for cancer: a retrospective cohort study.
abstract: OBJECTIVE
  To investigate the correlation between intraoperative body temperature and postoperative adverse effects in patients who underwent esophagectomy procedures.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University Hospital.
  
  
  METHODS
  One hundred twenty-one patients undergoing esophagectomy were enrolled.
  
  
  METHODS
  None.
  
  
  RESULTS
  Various perioperative and intraoperative variables were recorded. Hypothermia was defined as a urinary bladder temperature<35°C. Multiple logistic regression analysis was conducted to identify independent significant predictors of postoperative complications. In addition, the authors also determined a cutoff point for intraoperative minimum urinary bladder temperature by analyzing receiver operating characteristic (ROC) curves for occurrence of adverse events at 1 month after surgery. No patients died within 1 month after the surgery. There were 53 patients with early postoperative complications, and 51 had experienced intraoperative hypothermia. Factors that were correlated significantly with complications included age (p=0.02); hypothermia (p<0.01); and doses of ephedrine (p<0.01), phenylephrine (p<0.01), and fentanyl (p<0.01). Multiple logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio 2.57; 95% confidence interval 1.09-6.08). The area under the ROC curve for body temperature was 0.71, and the cutoff point was 35°C (sensitivity=0.65, specificity=0.72).
  
  
  CONCLUSIONS
  Intraoperative hypothermia was identified as an independent risk factor for early postoperative adverse events following esophagectomy.
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: joudannz@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamasaki
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Funai
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Suehiro
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazutake
authors.initials: K
authors.lastname: Ikenaga
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Harushi
authors.initials: H
authors.lastname: Osugi
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kiyonobu
authors.initials: K
authors.lastname: Nishikawa
mesh_terms: D000368:Aged; D001831:Body Temperature / Q000502:physiology*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007035:Hypothermia / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
keywords: body temperature; esophageal cancer; esophagectomy; intraoperative hypothermia