Impacts of extreme temperature events on intraoperative hypotension: Evidence from a multicenter cohort study of 276,515 patients.

作者：Ruijian Huang, Dan Cheng, Chen Zhang, Cheng Qian, Xuan Yin, Si-Yu Kong, Xinchi Li, Qilian Tan, Ya-Li Ge, Xuesheng Liu, Hong-Wei Shi, Fan Yang, Xiao Ning, Zhi-Min Zhang, Li-Hai Chen, Jie Sun, Jifang Zhou · 发表于：Journal of clinical anesthesia · 年份：2025 · DOI：10.1016/j.jclinane.2025.112049 · 被引用次数：1 · 研究领域：Medicine

BACKGROUND Extreme temperature events (ETEs) pose increasing risks for surgical patients, who may be vulnerable to temperature fluctuations. The associations between ETEs and intraoperative hypotension (IOH) remain understudied. METHODS We conducted a retrospective cohort analysis on patients undergoing major surgery between 2015 and 2023 at three large academic centers. ETEs were defined using percentile-based temperature thresholds and duration. Heat waves were periods of at least 3 consecutive days with daily average temperatures at or above the 95th or 97.5th percentiles of the previous 30 days, while cold spells were periods with temperatures at or below the 5th or 2.5th percentiles. The primary outcome was IOH ≥10 min, defined as a mean arterial pressure < 65 mmHg for ≥10 min. Secondary outcome was the duration of IOH ≥10 min. Logistic regression and generalized linear models were used to assess associations, adjusting for relevant covariates. RESULTS Among 276,515 eligible subjects, 48,023 were exposed to heat waves, 42,615 to cold spells, and 185,877 remained unexposed. The presence of an arterial catheter was noted in 30.31 % of the patients. Heat waves were associated with a reduced risk of IOH lasting ≥10 min (adjusted odds ratio [aOR], 0.80; 95 % confidence interval [CI], 0.76-0.84; P < 0.001). The total difference in IOH duration across the range of 30-day average temperatures from 0 to 30 °C was approximately 4 min, highlighting the modest magnitude of the e...