Perioperative hypothermia is associated with increased 30-day mortality in hip fracture patients in the UK. Α systematic review and meta-analysis

Abstract

Introduction/Objectives: Peri-operative hypothermia is common in trauma and surgical patients. The aim of this study was to undertake a systematic review and meta-analysis to determine the relationship between perioperative hypothermia and mortality following surgery for hip fracture. A systematic literature search of Medline, EMBASE, CINAHL, and Cochrane CENTRAL databases was performed using the Cochrane methodology for systematic reviews. The identified studies were assessed and compared against predetermined inclusion and exclusion criteria. Data extraction and quality appraisal was performed on selected articles. A meta-analysis was conducted using a random-effects model. The literature search identified 1016 records. After removing duplicates and those not meeting inclusion criteria, 3 studies measuring 30-day mortality were included. All included studies were carried out in the UK. The mortality rate was higher in the hypothermic groups as compared to the normothermic group in all the studies, with the difference being significant in two of the studies (p<0.0001). The meta-analysis showed that low body temperature was associated with an increased mortality risk (estimated OR: 2.660; 95%CI:1.948-3.632, P<0.001) in patients undergoing surgery for hip fracture. This study shows that low body temperature in hip fracture patients is associated with an increased 30-day mortality risk in the UK. Randomised control trials are required to determine whether the association between perioperative hypothermia in hip fracture patients and mortality is causal. Nevertheless, based on this analysis we urge the maintenance of normal body temperature in the peri-operative period to be included in national hip fracture guidelines. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. [Abstract copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.]