Effect of Body Temperature Protection on Intraoperative Bleeding in Elderly Patients Undergoing Arthroplasty: A Meta-Analysis.

BACKGROUND: Artificial joint replacement has become one of the most effective means for the clinical treatment of senile degenerative end-stage bone and joint diseases. All complications were directly or indirectly related to bleeding, and low body temperature can lead to bleeding, which have been a conceren in rthroplasty for elderly patients.

METHODS: The computer retrieves eight databases, including Cochrane Library, PubMed, EMbase, Web of Science, CNKI, China Biomedical Literature Database (CBM), VIP and WanFang, to obtain controlled trials at home and abroad on the effects of body temperature protection on intraoperative bleeding in elderly patients undergoing arthroplasty. The search term is "temperature", "bleeding," and "arthroplasty". The search time was from the establishment of the library until February 2022. The literature screening results were obtained by reading the full text, and the process was completed independently by 2 researchers.After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software.

RESULTS: 9 studies were ultimately included in this meta-analysis. 8 studies reported the blood loss of the test group and the control group. Meta-analysis showed that the blood loss of the test group was significantly lower (SMD: -45.09; 95% Cl: -67.76, -22.43; P < .01) than the control group. 44 studies showed that the Number of blood transfusions of the experimental group was significantly lower than the control group (OR:0.60; 95% Cl: 0.39,0.92; P = .01). 3 studies showed that the intraoperative temperature of the experimental group was significantly higher than the control group (SMD:0.60; 95% Cl: 0.20,0.99; P = .003). 4 studies showed that the postoperative temperature of the test group was significantly higher than the control group (SMD: 0.83; 95% Cl: 0.47,1.19; P < .01). 4 studies showed that the shiver incidence of the experimental group was significantly lower than the control group (OR:0.29; 95% Cl: 0.19,0.46; P < .01).

CONCLUSION: The results of this study suggest that active body temperature protection may be effective on intraoperative bleeding in elderly patients undergoing arthroplasty, as evidenced by blood loss, number of blood transfusions, intraoperative temperature, postoperative temperature, shiver incidence, length of hospital stay.