This single-centre retrospective study compared intraoperative temperature categories in 175 patients undergoing emergency surgery for acute aortic syndrome; 89% underwent hemiarch replacement. Overall, 30-day mortality was 18.9% and stroke incidence was 19.4%. In hemiarch patients, warmer temperatures were associated with lower stroke incidence and shorter ICU stays in unadjusted comparisons. However, adjusted four-category comparisons were not statistically significant for assessed outcomes. A sensitivity analysis using a 24.0°C threshold found an independent association with reduced stroke risk (OR 0.23, 95% CI 0.08–0.64), highlighting the dependence of findings on how temperature was categorized.
Temperature strategy was associated with postoperative outcomes, but the adjusted findings differed by categorization. These results are hypothesis-generating rather than evidence that warmer strategies prevent stroke.
Study limitation: The single-centre retrospective design leaves potential residual confounding, and the significant sensitivity analysis contrasted with nonsignificant adjusted four-category comparisons.
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