Risk factor and predictive score of the intraperative hypothermia in pediatric patients

Abstract

Background: Inadvertent intraoperative hypothermia, defined as a decrease in core temperature of 35℃, is a common problem in patients undergoing anesthesia which can result in adverse consequences. Therefore, maintaining normothermia, especially in pediatric patients is a primary concern. This study aims to identify the incidence of intraoperative hypothermia and its risk factors for developing a risk prediction score. Methods: A retrospective cohort study of 940 children under the age of 12 years underwent anesthesia in 2020 at Songklanagarind Hospital, Thailand, with one episode of body temperature <35℃ indicated a mild and 35.1-35.9℃ indicated a very mild hypothermia . Data, including patient demographics, clinical information, and perioperative data, were extracted from the hospital information system and were analyzed to identify the potential risk factors. The variables associated with intraoperative hypothermia at a p-value <0.2 then were included in the multivariate logistic regression analysis to establish a prediction model. Results: Among 940 patients, 34 (3.62%) patients experienced intraoperative hypothermia. After multivariate logistic regression analysis, a final model demonstrated that intraoperative hypothermia with a body temperature of less than or equal to 35 °C was associated with ASA physical status > III (Adj OR 15.41 (7.13, 33.27), p<0.001), Preoperative body temperature > 37.2°C (Adj OR3.31 (1.47, 7.44), p=0.006), anesthetic time > 2 hours (Adj OR 3.14 (1.34, 7.37), p=0.006), and no active warming (Adj OR 9.25 (2.87, 29.82), p<0.001) The risk prediction score with a cut-off point of 1 was chosen with sensitivity and specificity of 85.9% and 52.53% respectively. The final model showed good discrimination with an AUC of 0.775. Conclusions: The risk prediction score for predicting intraoperative hypothermia with a cut-off point of 1, especially in patients who had a score more than 2.75 can help clinical physicians in early detection of intraoperative hypothermia and prevent adverse consequences caused by intraoperative hypothermia.