Incidence of postoperative hypothermia and shivering and risk factors in patients undergoing malignant tumor surgery: a retrospective study.
Malignant tumor surgery
Postoperative hypothermia
Risk factors
Shivering
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
23 01 2023
23 01 2023
Historique:
received:
13
11
2022
accepted:
18
01
2023
entrez:
23
1
2023
pubmed:
24
1
2023
medline:
26
1
2023
Statut:
epublish
Résumé
Perioperative hypothermia and shivering are common and can cause adverse outcomes. The aim of this study was to investigate the incidence of postoperative hypothermia and shivering and their risk factors in patients undergoing malignant tumor surgery. This retrospective study collected data from patients with American Society of Anesthesiologists physical status (ASA) I or II who underwent scheduled surgery from November 2020 to March 2021 at Fudan University Shanghai Cancer Center. Each patient's core body temperature was measured at three time points: time point 1 (arrival at the postanesthesia care unit (PACU)), time point 2 (after 30-min care in the PACU), and time point 3 (at discharge from the PACU). At time point 1, if the patient's body temperature was below 36 ℃, we provided an active forced-air warmer. At time point 2, if it was still below 36 ℃, the forced-air warmer was still applied until the patient was discharged from the PACU. If it reached 36 ℃, the forced-air warmer would be switched off. Univariate and multivariate logistic regression combined with stepwise methods and linear regression were used to explore risk factors for postoperative hypothermia and shivering. The numbers (percentage) of 202 patients who developed postoperative hypothermia at the different time points were 52 (25.7%), 37 (18.3%) and 28 (13.9%). Eight patients (4.0%) experienced shivering. Multivariate logistic regression showed that high weight (OR = 0.923, 95% CI: 0.884 to 0.964, P = 0.0003) and low estimated blood loss (OR = 0.252, 95% CI: 0.115 to 0.550, P = 0.0005) were protective factors against hypothermia, while long surgical duration (OR = 3.339, 95% CI: 1.675 to 6.655, P = 0.0006) was an independent risk factor for hypothermia at time point 1. There was no risk factor associated with the occurrence of shivering (P > 0.05). There was a significant difference between the hypothermia and normothermia groups in the median length of stay in the PACU (59.0 vs. 49.0 min, P = 0.0123). Postoperative hypothermia occurred frequently. Weight, estimated blood loss and surgical duration were significantly associated with hypothermia on arrival at the PACU.
Sections du résumé
BACKGROUND
Perioperative hypothermia and shivering are common and can cause adverse outcomes. The aim of this study was to investigate the incidence of postoperative hypothermia and shivering and their risk factors in patients undergoing malignant tumor surgery.
METHODS
This retrospective study collected data from patients with American Society of Anesthesiologists physical status (ASA) I or II who underwent scheduled surgery from November 2020 to March 2021 at Fudan University Shanghai Cancer Center. Each patient's core body temperature was measured at three time points: time point 1 (arrival at the postanesthesia care unit (PACU)), time point 2 (after 30-min care in the PACU), and time point 3 (at discharge from the PACU). At time point 1, if the patient's body temperature was below 36 ℃, we provided an active forced-air warmer. At time point 2, if it was still below 36 ℃, the forced-air warmer was still applied until the patient was discharged from the PACU. If it reached 36 ℃, the forced-air warmer would be switched off. Univariate and multivariate logistic regression combined with stepwise methods and linear regression were used to explore risk factors for postoperative hypothermia and shivering.
RESULTS
The numbers (percentage) of 202 patients who developed postoperative hypothermia at the different time points were 52 (25.7%), 37 (18.3%) and 28 (13.9%). Eight patients (4.0%) experienced shivering. Multivariate logistic regression showed that high weight (OR = 0.923, 95% CI: 0.884 to 0.964, P = 0.0003) and low estimated blood loss (OR = 0.252, 95% CI: 0.115 to 0.550, P = 0.0005) were protective factors against hypothermia, while long surgical duration (OR = 3.339, 95% CI: 1.675 to 6.655, P = 0.0006) was an independent risk factor for hypothermia at time point 1. There was no risk factor associated with the occurrence of shivering (P > 0.05). There was a significant difference between the hypothermia and normothermia groups in the median length of stay in the PACU (59.0 vs. 49.0 min, P = 0.0123).
CONCLUSIONS
Postoperative hypothermia occurred frequently. Weight, estimated blood loss and surgical duration were significantly associated with hypothermia on arrival at the PACU.
Identifiants
pubmed: 36690942
doi: 10.1186/s12871-023-01991-8
pii: 10.1186/s12871-023-01991-8
pmc: PMC9869522
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
31Informations de copyright
© 2023. The Author(s).
Références
Anesthesiology. 2008 Jan;108(1):71-7
pubmed: 18156884
Lancet. 2016 Jun 25;387(10038):2655-2664
pubmed: 26775126
J Clin Nurs. 2022 Sep;31(17-18):2584-2592
pubmed: 34750903
BMC Anesthesiol. 2022 Feb 7;22(1):40
pubmed: 35130863
PLoS One. 2015 Sep 11;10(9):e0136136
pubmed: 26360773
J Perianesth Nurs. 2010 Oct;25(5):286-9
pubmed: 20875882
PLoS One. 2019 Dec 23;14(12):e0226038
pubmed: 31869333
Ann Med Surg (Lond). 2021 Nov 14;72:103059
pubmed: 34840773
J Coll Physicians Surg Pak. 2020 Feb;30(2):123-128
pubmed: 32036816
World J Surg. 2013 Feb;37(2):240-58
pubmed: 22956014
J Clin Anesth. 2016 Nov;34:547-54
pubmed: 27687449
Surg Endosc. 2017 Apr;31(4):1923-1929
pubmed: 27734204
Gynecol Oncol. 2013 Dec;131(3):525-30
pubmed: 24016410
BMC Anesthesiol. 2022 Feb 28;22(1):56
pubmed: 35227213
N Engl J Med. 1996 May 9;334(19):1209-15
pubmed: 8606715
Int J Clin Pract. 2021 Jun;75(6):e14103
pubmed: 33616248
Ann Surg Oncol. 2022 Jan;29(1):224-228
pubmed: 34668118
Cochrane Database Syst Rev. 2016 Oct 19;10:CD007821
pubmed: 27760282
PLoS One. 2021 Sep 23;16(9):e0257816
pubmed: 34555101
Dtsch Arztebl Int. 2015 Mar 6;112(10):166-72
pubmed: 25837741
Br J Anaesth. 1993 Apr;70(4):449-50
pubmed: 8499207
Int J Environ Res Public Health. 2021 Aug 19;18(16):
pubmed: 34444504
Anesth Analg. 2020 Nov;131(5):1430-1443
pubmed: 33079867
BMC Anesthesiol. 2022 Feb 28;22(1):55
pubmed: 35227219
Anesth Analg. 2016 May;122(5):1490-7
pubmed: 26895002
Obes Surg. 2001 Oct;11(5):570-5
pubmed: 11594097
BMC Anesthesiol. 2021 Aug 16;21(1):205
pubmed: 34399681
Dis Colon Rectum. 1999 Oct;42(10):1292-5
pubmed: 10528766
Ther Hypothermia Temp Manag. 2021 Dec;11(4):208-215
pubmed: 33524296
Medicine (Baltimore). 2020 Nov 25;99(48):e23424
pubmed: 33235123