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PLoS One. 2017 Jun 8;12(6):e0177221. doi: 10.1371/journal.pone.0177221. eCollection 2017.

Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China.

Yi J1, Lei Y2, Xu S3, Si Y4, Li S5, Xia Z6, Shi Y7, Gu X8, Yu J9, Xu G10, Gu E11, Yu Y12, Chen Y13, Jia H14, Wang Y15, Wang X16, Chai X17, Jin X18, Chen J19, Xu M20, Xiong J21, Wang G22, Lu K23, Yu W24, Lei W25, Qin Z26, Xiang J27, Li L28, Xiang Z29, Pan S29, Zhan L29, Qiu K29, Yao M29, Huang Y1.

Author information

1
Department of Anesthesiology, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China.
2
Department of Anesthesiology, the Second People's Hospital of Wuhu, Wuhu, Anhui, China.
3
Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.
4
Department of Anesthesiology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
5
Department of Anesthesiology, Quanzhou Women's and Children's Hospital, Quanzhou, Fujian, China.
6
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
7
Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou, Ganshu, China.
8
Department of Anesthesiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
9
Department of Anesthesiology, the Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China.
10
Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
11
Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
12
Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, China.
13
Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, Fujian, China.
14
Department of Anesthesiology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
15
Department of Anesthesiology, Haikou People's Hospital, Haikou, Hainan, China.
16
Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
17
Departement of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, China.
18
Department of Anesthesiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
19
Department of Anesthesiology, Ningbo No.2 Hospital, Ningbo, Zhejing, China.
20
Department of Anesthesiology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai, China.
21
Department of Anesthesiology, the Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
22
Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
23
Department of Anesthesiology, the First Affiliated Hospital of Chongqing Third Military Medical University, Chongqing, China.
24
Department of Anesthesiology, Tianjin First Central Hospital, Tianjin, China.
25
Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
26
Department of Anesthesiology, Nanfang Hospital, Guangzhou, Guangdong, China.
27
Department of Anesthesiology, the People's Hospital of Sanya, Sanya, Hainan, China.
28
Department of Anesthesiology, Sino-Japanese Union Hospital of Jilin University, Changchun, Jilin, China.
29
3M R&D Center, Shanghai, China.

Abstract

BACKGROUND/OBJECTIVE:

Inadvertent intraoperative hypothermia (core temperature <36°C) is a frequently preventable complication with several adverse consequences. Our study aimed to determine the overall incidence of inadvertent intraoperative hypothermia and its risk factors associated with clinical outcomes in this national survey in China.

METHODS:

We conducted a national cross-sectional study with 30 days postoperative follow-up from November 2014 through August 2015. A total of 3132 eligible patients underwent general anesthesia were randomly selected from 28 hospitals in the nationwide of China.

RESULTS:

The overall incidence of intraoperative hypothermia was as high as 44.3%, in which cumulative incidence rates of hypothermia being 17.8%, 36.2%, 42.5% and 44.1% within 1 h, 2 h, 3 h and 4 h respectively following induction of anesthesia. All patients were warmed passively by covering of surgical draping, sheets or cotton blankets, whereas only 14.2% of patients received active warming with space heaters or electric heater or electronic blankets. Compared to normothermic patients, patients with hypothermia is associated with more postoperative ICU admit, longer PACU and more postoperative hospital days, but no difference in surgical site infection (SSI) rates or 30-day mortality. Several factors were shown to be associated with decreased risk of hypothermia. They are active warming (OR = 0.46, 95% CI 0.26-0.81), BMI ≥ 25 (OR = 0.54, 95% CI 0.45-0.65), higher baseline core temperature (OR = 0.04, 95% CI 0.03-0.06), and higher ambient temperature (OR = 0.83, 95% CI 0.78-0.88). Risk factors associated with an increased risk of hypothermia included major-plus surgery (OR = 1.49, 95% CI 1.23-1.79), and long anesthesia (>2 h) (OR = 2.60, 95% CI 2.09-3.24).

CONCLUSIONS:

The incidence of intraoperative hypothermia in China is high, and the rate of active warming of patients during operation is low. Hypothermia is associated with more postoperative shivering, increased ICU admissions, and longer postoperative hospital days.

PMID:
28594825
PMCID:
PMC5464536
DOI:
10.1371/journal.pone.0177221
[Indexed for MEDLINE]
Free PMC Article

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