John P Kleimeyer1, Alex H S Harris, Joseph Sanford, William J Maloney, Bassam Kadry, Julius A Bishop. 1. From the Department of Orthopaedic Surgery (Dr. Kleimeyer, Dr. Maloney, and Dr. Bishop), and the Department of Anesthesiology (Dr. Kadry), Stanford University School of Medicine, Stanford, CA, and Center for Innovation to Implementation, VA Palo Alto Health Care System, Livermore, CA (Dr. Harris), and the Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR (Dr. Sanford).
Abstract
INTRODUCTION: Postoperative hypothermia is a common complication of orthopaedic surgery associated with increased morbidity. We identified the incidence and risk factors for postoperative hypothermia across orthopaedic surgical procedures. METHODS: A total of 3,822 procedures were reviewed. Hypothermia was defined as temperature <36.0°C. Incidences were calculated and associated risk factors were evaluated by mixed-effects regression analyses. RESULTS: Hypothermia was observed in 72.5% of patients intraoperatively and 8.3% postoperatively. Risk factors for postoperative hypothermia included intraoperative hypothermia (odds ratio [OR], 2.72), lower preoperative temperature (OR, 1.46), female sex (OR, 1.42), lower body mass index (OR, 1.06 per kg/m), older age (OR, 1.02 per year), adult reconstruction by specialty (OR, 4.06), and hip and pelvis procedures by anatomic region (OR, 8.76). DISCUSSION: Intraoperative and postoperative hypothermia are common in patients who have undergone orthopaedic surgery. The high-risk groups identified in this study warrant increased attention and should be targets for interventions to prevent hypothermia and limit morbidity. LEVEL OF EVIDENCE: Level IV, prognostic study.
INTRODUCTION:Postoperative hypothermia is a common complication of orthopaedic surgery associated with increased morbidity. We identified the incidence and risk factors for postoperative hypothermia across orthopaedic surgical procedures. METHODS: A total of 3,822 procedures were reviewed. Hypothermia was defined as temperature <36.0°C. Incidences were calculated and associated risk factors were evaluated by mixed-effects regression analyses. RESULTS:Hypothermia was observed in 72.5% of patients intraoperatively and 8.3% postoperatively. Risk factors for postoperative hypothermia included intraoperative hypothermia (odds ratio [OR], 2.72), lower preoperative temperature (OR, 1.46), female sex (OR, 1.42), lower body mass index (OR, 1.06 per kg/m), older age (OR, 1.02 per year), adult reconstruction by specialty (OR, 4.06), and hip and pelvis procedures by anatomic region (OR, 8.76). DISCUSSION: Intraoperative and postoperative hypothermia are common in patients who have undergone orthopaedic surgery. The high-risk groups identified in this study warrant increased attention and should be targets for interventions to prevent hypothermia and limit morbidity. LEVEL OF EVIDENCE: Level IV, prognostic study.