Influència de la temperatura ambiental i corporal com a factors de risc en les morbi-mortalitats postoperatori de les neoplàsies colorectals electives

Abstract

Morbidity and the postoperative mortality of our patients, and especially the surgical site infection, are some of the medical complications that concern daily any surgeon. All of them cause a significant impact on the patient and at the same time involve high socioeconomic costs in health sector. So here is born the importance of knowing the possible causes that influence the appearance of each one. This medical research is focused on the relationship between several postoperative morbidities and the mortality with perioperatory risk factors in the elective surgery of colorectal cancer. It has been analyzed 30 perioperative factors, with special emphasis on patient’s body temperature and room temperature to find out in detail if there is some causal or protective connection in order to act on them as much as possible. Patients used are patients who were operated under suspected diagnosis of colon or rectum cancer, with some mecanic suture, with no other exclusion criteria and consecutively collected from University Hospital Germans Trias i Pujol, from October 2008 to June 2011. We have observed that hypothermia acts as a risk factor for several postoperative morbidity but at the same time it also acts as a protective factor for some of them and for postoperative mortality. Nevertheless, it only works as a risk factor for various morbidity in the case of low room temperature. Both factors are within our reach to be modified and adjusted to avoid some of the different postoperative morbidities. We have also noticed that the clinical eye of each surgeon based on their experience, knowledge and surgical findings that makes to schedule the postoperative antibiotics in some patients -a not regular practice in our center done according to the criteria of each surgeon-, it also acts as a risk factor for several postoperative septic morbidities. As well, we have found that older age, or a history of COPD or an previous history of hepatopathy act as risk factors for a large variety of postoperative complications. So, patients who have one or more of these three factors are most risk patients. We have also made clear that patients with a rectum neoplasia have less risk of an earlly organ premature site infection than patients with a colon neoplasia. Therefore, a rectum surgery is a protective factor for this complication. And finally, we have also observed that the several risk index analyzed is related to an increased risk of medical complications, even in septic or non-septic. With all of these results we have seen that there are many risk factors that can be avoided and it is up to the surgeon, the anaesthesiologist and nursing to avoid them and change them, but others that can not be changed then we can change our therapeutic attitude, the postsurgical controls or the postoperative measures. All this is to help us improve our day to day work.

Date of Award	30 Sept 2013
Original language	Spanish
Supervisor	Jose Maria Balibrea del Castillo (Director), Benjamin Oller Sales (Director) & Marta Piñol Pascual (Director)