Safety of intraoperative hypothermia for patients: meta-analyses of randomized controlled trials and observational studies

Xu, He; Wang, Zijing; Guan, Xin; Lu, Yijuan; Malone, Daniel Charles; Salmon, Jack Warren; Ma, Aixia; Tang, Wenxi

doi:10.1186/s12871-020-01065-z

Table 2 Basic features of the included studies

From: Safety of intraoperative hypothermia for patients: meta-analyses of randomized controlled trials and observational studies

Studies	country	Population	Study type	Participants			Outcome indicators	Risk Difference (95%CI)	Mean Difference (95%CI)
Studies	country	Population	Study type	Hypothermic	Normothermic1	Normothermic2	Outcome indicators	Risk Difference (95%CI)	Mean Difference (95%CI)
Yu et al (2010) [11]	China	patients undergoing opening radical resection of distal gastric cancer age:EG:60·20±13·30 CG:59·86±11·13	Randomised, controlled trial	32	54	\	Surgical site infection	0·15 [0·01, 0·29]	\
							Intraoperative bleed	\	158·48 [85·74, 231·22]
							Length of stay	\	1·99 [0·95, 3·03]
Zhang et al (2009) [18]	China	patients undergoing radical resection for carcinoma of esophagus age: EG:59±6 CG①: 59±7 CG②: 59±9^a	Randomised, controlled trial	10	10^b	10^b	Shivering (EG vs CG1)	0·30 [-0·10, 0·70]	\
Zhang et al (2009) [18]	China		Randomised, controlled trial	10	10^b	10^b	Shivering (EG vs CG2)	0·60 [0·25, 0·95]	\
Todd et al (2009) [19]	America	patients undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage	Randomised, controlled trial	499	501	\	mortality	-0·01 [-0·04, 0·02]	\
Nathan et al (2004) [20]	Canada	patients undergoing elective coronary artery surgery with cardiopulmonary bypass aged over 60 years age:EG:68±6 CG:70±7	Randomised, controlled trial	71	73	\	Length of stay	\	-0·20 [-1·11, 0·71]
Nathan et al (2004) [20]	Canada		Randomised, controlled trial	71	73	\	mortality	0·03 [-0·02, 0·07]	\
Frank et al (1997) [21]	America	patients undergoing abdominal, thoracic, or vascular surgical procedures aged 71±1 years	Randomised, controlled trial	158	142	\	Intraoperative bleed	\	130·00 [115·16, 144·84]
							Length of surgery	\	-0·20 [-0·43, 0·03]
							Shivering	0·18 [0·10, 0·25]	\
							mortality	-0·00 [-0·03, 0·02]	\
Lenhardt et al (1997) [22]	America	patients undergoing elective major abdominal surgery age : EG:55±16 CG:56±17	Randomised, controlled trial	76	74	\	Length of surgery	-0·20 [-0·57, 0·17]	\
Kurz et al (2) (1996) [23]	America	patients undergoing elective colorectal resection age : EG:59±14 CG:61±15	Randomised, controlled trial	96	104	\	Surgical site infection	0·13 [0·04, 0·22]	\
Kurz et al (2) (1996) [23]	America		Randomised, controlled trial	96	104	\	Length of stay	\	2·60 [1·05, 4·15]
Schmied et al (1996) [24]	Austria	patients undergoing unilateral total hip arthroplasties aged 63±10 year	Randomised, controlled trial	30	30	\	Intraoperative bleed	\	230·00 [64·89, 395·11]
Kurz et al (1996) [25]	America	patients undergoing elective colon surgery averagely aged 58 years age : EG:59±14 CG:57±15	Randomised, controlled trial	35	39	\	Length of surgery	\	0·20 [-0·35, 0·75]
Yamada et al (2019) [26]	Japan	patients undergoing orthopaedic surgery age : EG: 68·6 ±16·6 CG: 65·8 ±17·2	Observational study	1088	7833	\	Surgical site infection	-0·00[-0·01, 0·00]	\
Yamada et al (2019) [26]	Japan		Observational study	1088	7833	\	mortality	0·00 [-0·00, 0·01]	\
Xiehe (2018)^c	China	Patients undergoing esophageal/pancreatic surgery age : EG: 60·6±9·6 CG: 58·0±11·4	Observational study	103	137	\	Surgical site infection	-0·00[-0·12, -0·00]	\
							Length of surgery	\	0·00 [-23·35, 23·35]
							Length of stay	\	-2·70 [-5·78, 0·38]
Williams et al (2018) [27]	England	patients undergoing total joint arthroplasty age : EG:72·0 ±10·0 CG: 71·3 ±10·3	Observational study	240	1815	\	Length of surgery	\	-5·00 [-9·08, -0·92]
							Length of stay	\	-0·50 [-0·92, -0·08]
							readmission	-0·01 [-0·04, 0·01]	\
Frisch et al(2) (2017) [28]	America	patients undergoing total hip and knee arthroplasty age : EG: 66·3±10·4 CG: 66·1±10·7	Observational study	887	1510	\	Length of surgery	\	0·70 [-2·05, 3·45]
							Length of stay	\	0·10 [-0·09, 0·29]
							readmission	0·00 [-0·02, 0·02]	\
Henriksen et al (2016) [29]	Denmark	patients diagnosed of infections age : EG: 75·8 [71·9-79·7] CCG: 72·8 [71·8-73·7]	Observational study	64	1216	\	mortality	0·19 [0·07, 0·31]	\
Frisch et al (2016) [13]	America	patients undergoing operative treatment of a hip fracture age : EG: 79·6±11·9 CG: 77·2±14·6	Observational study	260	1265	\	Length of surgery	\	-4·90 [-10·89, 1·09]
							Length of stay	\	-0·50 [-1·39, 0·39]
							readmission	-0·02 [-0·07, 0·03]	\
Tsuchida et al (2015) [12]	Japan	patients undergoing gastroenterologic surgery aged 15-92 years age : 61·2 ± 15·7 (15-92)	Observational study	528	881	\	Surgical site infection	-0·00[-0·04, 0·04]	\
Billeter et al (2014) [30]	America	patients undergoing elective operation age : EG: 61·3 ± 16·8 CG: 60·7 ± 16·3	Observational study	707	698	\	Surgical site infection	0·02 [-0·00, 0·04]	\
							Length of stay	\	5·50 [3·09, 7·91]
							mortality	0·13 [0·10, 0·16]	\
							Length of ICU stay	\	98·40 [60·75, 136·05]
Jeyadoss et al (2014) [31]	Australia	patients undergoing abdominal aortic aneurysm repair aged 71·8±6·9 years	Observational study	66	36	\	Length of stay	\	0·22 [-0·90, 1·34]
Jeyadoss et al (2014) [31]	Australia		Observational study	66	36	\	Length of ICU stay	\	30·00 [11·11, 48·89]
Kebria et al (2012) [32]	England	patients undergoing debulking surgery aged 63·9± 11·7 years	Observational study	81	65	\	mortality	0·06 [0·00, 0·12]	\
Kebria et al (2012) [32]	England	patients undergoing debulking surgery aged 63·9± 11·7 years	Observational study	81	65	\	readmission	0·05 [-0·01, 0·11]	\
Williams et al (2) (2018) [33]	England	patients undergoing hip fracture operations age: EG: 87·1 ±7·8 CG: 84·7 ±7·8	Observational study	92	837	\	Length of surgery	\	-4·90 [-11·34, 1·54]
							Length of stay	\	0·30 [-1·19, 1·79]
							mortality	0·05 [-0·02, 0·11]	\
							Readmission	0·08 [0·01, 0·14]	\

^aEG experimental group, CG control group
^bThis study actually used different warming methods as the control group, since the temperature of the control groups were below 36°C and the experimental group was above 36°C, they were all included· Experimental group warming method: active warming Thermacare○R; Control group 1 warming mode: after induction of general anesthesia, the lower body continued heating; Control group 2 warming mode: no warming·
^cThe RCT included 240 patients who underwent esophagectomy or pancreatectomy at Peking Union Medical College Hospital from 11 October 2016 to 28 March 2018. Identifier: ChiCTR-IPR-17011099. Available at: http://www.chictr.org.cn/historyversionpub.aspx?regno=ChiCTR-IPR-17011099

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