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. 2024 Sep 25;16(9):e70139.
doi: 10.7759/cureus.70139. eCollection 2024 Sep.

Perioperative Hypothermia in Surgical Patients: A Retrospective Cohort Analysis at a Busy District General Hospital

Zain Habib  1 , Mohammed Arifuzaman  2 , Apurv Gupta  2 , Neil Muscat  3 , Sherif I Fawzy  4 , Muhammad Umer Rasool  1 , Ahmed Elbeltagi  5 , Syed Ali Abbas Bilgrami  6 , Muhammed Suneer Puthan Peedika  5 , Sayan Bhattacharya  2
Affiliations

Perioperative Hypothermia in Surgical Patients: A Retrospective Cohort Analysis at a Busy District General Hospital

Zain Habib et al. Cureus. .

Abstract

Introduction Perioperative hypothermia is a common yet underreported complication of surgery. It results from various factors, including cold operating theaters, anesthetic effects, environmental exposure, exposed tissues, and the administration of cold intravenous or irrigation fluids. This study aims to determine the incidence of perioperative hypothermia in a district National Health Service hospital to assess the feasibility of a randomized controlled trial (RCT) for interventions to prevent hypothermia. Methods This retrospective study included the data of 200 elective surgical patients at North Manchester General Hospital from June 1, 2022, to August 1, 2022. Inclusion criteria were elective general surgery, urology, breast, and gynecology patients aged 18 to 60 years. Exclusion criteria included emergency cases and patients younger than 18 or older than 60. Temperature measurement data were collected from the anesthesia records of the patients at six phases: preoperative, pre-induction, intraoperative, post-procedure, recovery room, and post-recovery. Data collection included specialty, surgery duration, and the use of intraoperative fluid warmers. Statistical analysis was performed using StatsDirect software (StatsDirect Ltd, Wirral, UK). Results Among the 200 patients, the overall incidence of hypothermia was 4% preoperatively, 5% pre-induction, 12% intraoperatively, 11% postoperatively, 8% in recovery, and 6% post-recovery. Intraoperative hypothermia incidence was significant, given that active warming was applied to patients with preoperative hypothermia. Regression analysis showed no correlation between intraoperative temperature and the use of intraoperative fluid warmers. Pre-induction temperature was the most statistically significant predictor of intraoperative hypothermia. Conclusions This study highlights the need for active interventions to recognize and prevent perioperative hypothermia in elective surgical patients. Active pre-warming of patients, regardless of surgery type and duration, is feasible and potentially beneficial. Future research should include an RCT comparing active and passive warming strategies to evaluate their effectiveness in improving perioperative outcomes.

Keywords: anesthesia; core body temperature; hypothermia; perioperative hypothermia; surgery.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Incidence of hypothermia per specialty
Figure 2
Figure 2. Incidence of hypothermia in different phases of surgery
Figure 3
Figure 3. Intraoperative hypothermia incidence per specialty
Figure 4
Figure 4. Line fit plot for the intraoperative patient core body temperature and use of intraoperative fluid warmers
Figure 5
Figure 5. Line fit plot after regression analysis between duration of surgery in minutes and intraoperative patient temperature
Figure 6
Figure 6. Line fit plot after multiple regression analysis between preoperative and intraoperaive temperatures
Figure 7
Figure 7. Line fit plot after multiple regression analysis between pre-induction and intraoperative temperatures
See this image and copyright information in PMC

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