Impact of perioperative temperature management nursing quality on postoperative infectious complications in patients undergoing gastrointestinal surgery

Table 1 Baseline characteristics and major perioperative clinical features, mean ± SD/n (%)

Variable	Case group (n = 9)	Control group (n = 36)	t/χ2 value	P value
Age (years)	62.32 ± 8.71	61.85 ± 9.12	0.139	0.890
Sex, male	6 (66.67)	21 (58.33)		0.721
BMI (kg/m2)	23.53 ± 3.21	24.16 ± 2.91	0.570	0.572
ASA ≥ III	4 (44.44)	13 (36.11)		0.711
Complicated with diabetes	3 (33.33)	10 (27.78)		0.704
Preoperative albumin (g/L)	36.22 ± 5.11	37.85 ± 4.72	0.912	0.367
Open surgery	5 (55.56)	17 (47.22)		0.722
Operation time (minutes)	185.65 ± 42.36	178.92 ± 38.71	0.458	0.649
Intraoperative fluid volume (mL)	1520.09 ± 320.23	1480.45 ± 290.67	0.359	0.721
Intraoperative blood loss (mL)	210.62 ± 85.78	195.09 ± 78.80	0.520	0.606

BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Comparison of perioperative body temperature management indicators between the two groups, mean ± SD/n (%)

Indicator	Case group (n = 9)	Control group (n = 36)	t/χ2 value	P value
Preoperative warming	3 (33.33)	22 (61.11)		0.157
Lowest intraoperative body temperature (°C)	35.22 ± 0.61	36.15 ± 0.42	5.409	< 0.001
Duration of hypothermia (minutes)	82.35 ± 25.61	28.75 ± 9.26	10.385	< 0.001
Intraoperative active warming	2 (22.22)	27 (75.00)		0.006
Immediate postoperative temperature (°C)	35.54 ± 0.72	36.34 ± 0.52	3.815	< 0.001
Temperature management compliance score	5.13 ± 1.31	8.47 ± 1.11	7.794	< 0.001

Table 3 Logistic analysis of temperature management measures during the perioperative period and postoperative infection

Variable	Univariate analysis			Multiplicity
	OR	95%CI	P value	OR	95%CI	P value
Minimum intraoperative body temperature (per 1 °C decrease)	4.320	1.608-11.121	0.002	3.850	1.420-10.430	0.008
Duration of hypothermia (per 30-minute increment)	2.870	1.420 to -5.811	0.003
Active heating (yes/no)	0.110	0.020-0.630	0.013
Intraoperative body temperature (per 1 °C decrease)	3.950	1.540-10.122	0.004
Compliance score (each point down)	2.050	1.210-3.480	0.008	1.820	1.050-3.160	0.032

OR: Odds ratio; CI: Confidence interval.

Table 4 Subgroup analysis of postoperative infections by surgical approach and diabetic status stratification

Stratification factor	Variable	Subgroup	Case/control	OR (95%CI)	P value	P for interaction
Surgical approach	Lowest intraoperative temperature (per 1 °C decrease)	Open surgery	5/17	5.231 (2.905-9.437)	0.002	0.046
		Laparoscopic surgery	4/19	2.152 (1.441-3.222)	0.138
	Compliance score (per 1-point decrease)	Open surgery	5/17	2.311 (1.564-3.421)	0.023	0.118
		Laparoscopic surgery	4/19	1.572 (0.951-2.602)	0.121
Diabetes status	Lowest intraoperative temperature (per 1 °C decrease)	With diabetes	3/10	6.125 (3.214-11.680)	0.001	0.049
		Without diabetes	6/26	3.012 (1.822-4.983)	0.045
	Compliance score (per 1-point decrease)	With diabetes	3/10	1.927 (0.994-3.751)	0.047	0.812
		Without diabetes	6/26	1.785 (0.911-3.501)	0.058

OR: Odds ratio; CI: Confidence interval.

Table 5 Comparison of mechanistic indicators of temperature management during the perioperative period and postoperative infection correlation, mean ± SD

Indicator	Case group (n = 9)	Control group (n = 36)	t value	P value
Intraoperative core temperature variability (°C)	0.48 ± 0.12	0.21 ± 0.07	8.873	< 0.001
Intraoperative core-to-skin temperature gradient (°C)	4.35 ± 1.02	2.67 ± 0.84	5.144	< 0.001
Intraoperative lactate clearance rate (%/hour)	18.32 ± 3.51	32.73 ± 4.11	9.654	< 0.001
Serum PCT (ng/mL) 2 hours postoperative	2.65 ± 0.76	0.82 ± 0.21	12.969	< 0.001
Immediate postoperative peripheral perfusion index	0.82 ± 0.31	1.45 ± 0.47	3.802	< 0.001
Temperature management response delay time (minutes)	24.65 ± 3.81	17.33 ± 2.24	7.541	< 0.001
Intraoperative FiO2 exposure index (%·minutes)	4820.20 ± 1050.13	4100.04 ± 890.23	2.096	0.042

PCT: Procalcitonin; FiO₂: Fraction of inspired oxygen.