{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:48:24Z","timestamp":1790668104995,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T00:00:00Z","timestamp":1552435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Clinical Research Fund of Tokyo Metropolitan Government","award":["H290101001"],"award-info":[{"award-number":["H290101001"]}]},{"name":"Grant-in-Aid for Scientific Research","award":["17K09151"],"award-info":[{"award-number":["17K09151"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Maintaining perioperative normothermia is recommended by recent guidelines for the prevention of surgical site infections (SSIs). However, the majority of supporting data originates outside the field of orthopaedic surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The effect of normothermia was explored using the prospectively collected data of consecutive patients who underwent single-site surgery in 7 tertiary referral hospitals between November 2013 and July 2016. SSIs, urinary tract infections (UTIs), respiratory tract infections (RTIs), cardiac and cerebral events (CCE), and all-cause mortality rates within 30 days after surgery were compared between patients with normothermia (body temperature \u226536\u00b0C) and those with hypothermia (&amp;lt;36\u00b0C) at the end of surgery, after closure. Multivariable adjusted and inverse-probability weighted regression analyses were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The final cohort included 8841 patients. Of these, 11.4% (n = 1008) were hypothermic. More than 96% were evaluated in person by the physicians. After adjusting for multiple covariates, normothermia was not significantly associated with SSIs (adjusted odds ratio [aOR] 1.18, 95% confidence interval [CI] 0.59\u20132.33), UTIs (aOR 1.14, 95% CI 0.66\u20131.95), RTIs (aOR 0.60, 95% CI 0.31\u20131.19), or CCE (aOR 0.53, 95% CI 0.26\u20131.09). In contrast, normothermia was associated with a lower risk of 30-day mortality (aOR 0.26, 95% CI 0.11\u20130.64; P &amp;lt; .01; weighted hazard ratio 0.21, 95% CI 0.07\u20130.68; P = .002). In a subgroup analysis, normothermia was associated with reduced mortality in all types of surgical procedures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Whereas our findings suggest no clear association with SSI risks following orthopedic surgery, our study supports maintaining perioperative normothermia, as it is associated with reduced 30-day mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz213","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T20:12:37Z","timestamp":1552335157000},"page":"474-482","source":"Crossref","is-referenced-by-count":15,"title":["Association Between Normothermia at the End of Surgery and Postoperative Complications Following Orthopedic Surgery"],"prefix":"10.1093","volume":"70","author":[{"given":"Koji","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Kanto Rosai Hospital , Kanagawa,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Kanto Rosai Hospital , Kanagawa,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Nakamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Kohata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Tama Medical Center ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Shinozaki","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Graduate School of Medicine ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyofumi","family":"Yamakawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Tama Medical Center ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Tokimura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kanai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Bokuto Hospital ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiro","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital , Kanagawa,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuro","family":"Karita","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Tama Medical Center ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Tajiri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Metropolitan Hiroo Hospital ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Kanto Rosai Hospital , Kanagawa,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo 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