Postoperative hypothermia and mortality in critically ill adults: review and meta‑analysis

Abstract

Objective: To identify, appraise and synthesise published literature about hospital mortality associated with inadvertent postoperative hypothermia of adult patients directly transferred to the Intensive Care Unit (ICU) after surgery.

Design: Systematic literature review and meta‑analysis.

Methods: Using key terms, a search was conducted in English‑language, peer‑reviewed journals indexed by CINAHL, PubMed and Cochrane Database focusing on articles published between 1980 and 2010. Data extraction and quality appraisal was performed. After evaluating heterogeneity among studies, quantitative synthesis was applied where possible.

Results: Seven observational studies met the inclusion criteria. In five of them, hospital mortality was significantly higher in hypothermic patients. Unadjusted odds ratio of core temperature<350C on hospital mortality was combined in a meta‑analysis and the pooled estimate was 3.29 (95% confidence interval 1.58‑6.85). In the multivariate level, independent associations between hypothermia and mortality were detected in four studies.

Conclusions: Existing evidence supports the positive association between postoperative hypothermia and hospital mortality in surgical ICU patients. Effective hypothermia prevention can be crucial for improving outcomes of this population, but further research is needed for confirming the independent contribution of hypothermia on mortality.