Efficiency and Safety of Temperatures Management in Aortic Arch Surgery: A System Review and Meta-Analysis

Table 1

Pooled outcomes with subgroup analysis.

Variables	Group	Temperature (degrees Celsius)	Patients’ numbers	Events	Estimate	Heterogeneity (I square) (%)	value	Interaction-p (subgroup-P value)
Age	A	30–32	3774	NA	63.70 [60.60; 66.81]	93	<0.01	0.06
	B	28–30	2081	NA	60.36 [54.61; 66.11]	99	<0.01
	C	26–28	531	NA	50.98 [38.34; 63.63]	99	<0.01
	D	24–26	13526	NA	59.30 [53.92; 64.67]	100	<0.001
	E	<24	14885	NA	57.81 [51.49; 64.13]	100	<0.001
	Pooled outcome		34797	NA	59.10 [56.50; 61.70]	100	<0.001
Sex (male)	A	30–32	3774	2540	0.67 [0.63; 0.70]	66	<0.01	<0.01
	B	28–30	2081	1444	0.70 [0.67; 0.73]	32	0.12
	C	26–28	531	405	0.76 [0.71; 0.80]	0	0.63
	D	24–26	13526	9817	0.73 [0.68; 0.77]	79	<0.01
	E	<24	14485	10190	0.71 [0.67; 0.73]	92	<0.01
	Pooled outcome		34797	24386	0.71 [0.69; 0.73]	84	<0.01
CPB time (minutes)	A	30–32	3774	NA	170.11 [154.74; 185.49]	96	<0.01	<0.01
	B	28–30	2081	NA	184.05 [171.27; 196.84]	91	<0.01
	C	26–28	531	NA	180.59 [155.29; 205.90]	90	<0.01
	D	24–26	13526	NA	197.22 [184.11; 210.33]	100	<0.001
	E	<24	11935	NA	206.25 [185.50; 227.01]	100	<0.001
	Pooled outcome		31847	NA	189.27 [182.04; 196.50]	100	<0.001
TNI	A	30–32	3774	166	0.04 [0.04; 0.05]	21	0.25	0.14
	B	28–30	1942	104	0.05 [0.04; 0.07]	0	0.55
	C	26–28	265	6	0.02 [0.01; 0.08]	0	0.75
	D	24–26	10723	444	0.05 [0.03; 0.09]	83	<0.01
	E	<24	5352	238	0.05 [0.04; 0.07]	73	<0.01
	Pooled outcome		22056	958	0.05 [0.04; 0.06]	62	<0.01
PNI	A	30–32	3774	109	0.03 [0.02; 0.05]	80	<0.01	0.02
	B	28–30	2081	142	0.07 [0.05; 0.09]	61	<0.01
	C	26–28	531	25	0.04 [0.02; 0.09]	22	0.26
	D	24–26	13526	1147	0.06 [0.04; 0.09]	88	<0.01
	E	<24	14885	1809	0.08 [0.05; 0.12]	90	<0.01
	Pooled outcome		34797	3232	0.06 [0.04; 0.07]	90	<0.01
RF	A	30–32	2005	119	0.08 [0.03; 0.20]	93	<0.01	0.01
	B	28–30	1623	106	0.06 [0.04; 0.09]	20	0.27
	C	26–28	494	32	0.05 [0.02; 0.13]	64	0.02
	D	24–26	6355	669	0.10 [0.06; 0.15]	91	<0.01
	E	<24	5855	779	0.12 [0.08; 0.17]	88	<0.01
	Pooled outcome		16332	1705	0.08 [0.06; 0.10]	89	<0.01
Mortality	A	30–32	3774	156	0.03 [0.02; 0.06]	76	<0.01	0.05
	B	28–30	2081	129	0.06 [0.05; 0.07]	27	0.17
	C	26–28	531	24	0.05 [0.03; 0.07]	10	0.35
	D	24–26	13526	920	0.07 [0.05; 0.08]	79	<0.01
	E	<24	14885	2070	0.07 [0.05; 0.12]	94	<0.01
	Pooled outcome		34797	3302	0.06 [0.05; 0.07]	93	<0.01

For the age variable, the pooled outcome is statistically significant with a P value <0.001. However, it is also worth noting the high heterogeneity (² = 100%), which suggests that there is a lot of variability in the results across the different age groups. And for the sex variable, the pooled proportion of males across all groups is 0.71, and this result is statistically significant with a P value <0.01. However, there is significant heterogeneity in the results across the groups (² = 84%). Besides, for CPB time, the pooled outcome is 189.27 minutes with a 95% confidence interval of (182.04 and 196.50), and the P value for the pooled outcome’s heterogeneity is <0.001, indicating that the heterogeneity is statistically significant. Finally, in all complication variables, including PNI, TNI, RF, and mortality, all suggest that there is a lot of variability in the results across the different groups with a P value <0.01.