Risk Factors Contributing to Inadvertent Postoperative Hypothermia in Adult Patients Following Hepatobiliary Surgery.

Abstract

Purpose: This investigation focused on identifying the incidence and risk factors associated with inadvertent postoperative hypothermia in patients undergoing hepatobiliary surgery.

Design: This is an observational cohort study.

Methods: This study, conducted at a single center, tracked adults undergoing hepatobiliary procedures from January 1, 2023, to January 1, 2024. Upon entering the Post-Anesthesia Care Unit (PACU), core body temperature measurements were recorded, along with demographic information, clinical metrics, and details of the surgical procedure. The patients admitted to the PACU were categorized into hypothermia and non-hypothermia groups based on whether their core body temperature was below 36°C. Logistic regression analysis was conducted to identify the risk factors contributing to inadvertent hypothermia during recovery from general anesthesia in this patient population.

Findings: In this study, 373 patients were enrolled: 205 were allocated to the hypothermia group and 168 to the non-hypothermia group. The independent risk factors for postoperative inadvertent hypothermia included duration of anesthesia (odds ratio [OR] = 1.01, CI: 1.00 to 1.02, P = .001), times of hepatic inflow occlusion (OR = 1.61, CI: 1.06 to 2.47, P = 0.027), use of infusion warming (OR = 14.19, CI: 1.88 to 107.25, P = .01), operation level (OR = 0.07, CI: 0.03 to 0.18, P < .001), American Society of Anesthesiologists' (ASA) classification (OR = 16.95, CI: 5.34 to 53.74, P < .001), type of surgery (open surgery) (OR = 3.80, CI: 2.10 to 6.90, P < .001), surgical site (liver) (OR = 7.07, CI: 2.80 to 17.82, P < .001), and surgical site (hepatobiliary) (OR = 5.29, CI: 2.09 to 13.37, P < .001).

Conclusions: The investigation revealed a significant incidence of hypothermia (54.95%) in patients undergoing hepatobiliary surgery upon their arrival at the PACU. A substantial correlation was established between hypothermia and various factors in the post-anesthesia recovery phase for those undergoing hepatobiliary operations. Influential factors included the duration of anesthesia, the times of hepatic inflow occlusion, application of infusion warming, the operation level, the ASA classification, and whether the procedure was an open surgery specifically targeting the liver or hepatobiliary region.