OBJECTIVE  To investigate the impact of intraoperative abnormal body temperature on postoperative intracranial infection, pulmonary infection （PI）and incision infection within 30 days after craniotomy.

METHODS  A total of 1 139 patients who underwent craniotomy at the First Affiliated Hospital of Zhengzhou University from May 2022 to Apr. 2025 were enrolled. Based on postoperative infection status, they were divided into an infection group （n=56） and a non-infection group （n=1 083）. General data of the two groups were analyzed. The postoperative infection status within 30 days was compared among patients with different cumulative durations of intraoperative hypothermia or hyperthermia. The influence of intraoperative abnormal body temperature on postoperative infections was explored.

RESULTS  Among the 1 139 craniotomy patients included in the study, 17 cases （1.49%） developed intracranial infection within 30 days postoperatively, 14 cases （1.23%） developed incision infection, and 25 cases （2.19%） developed PI. Compared with patients with a cumulative duration of intraoperative hypothermia of 0–30 minutes, a cumulative duration of ≥31 minutes was identified as a risk factor for postoperative intracranial infection, PI and incision infection. Compared with patients with a cumulative duration of intraoperative hyperthermia of 0–30 minutes, a cumulative duration of ≥31 minutes was also confirmed as a risk factor for postoperative intracranial infection, PI and incision infection.

CONCLUSION  Among patients undergoing craniotomy, prolonged intraoperative hypothermia and hyperthermia are both associated with postoperative infections.