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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

Preoperative Risk Factors of Intraoperative Hypothermia in Major Surgery Under General Anesthesia

T. Kasai, MD^*, M. Hirose, MD^*, K. Yaegashi, MD^*, T. Matsukawa, MD, A. Takamata, PhD, and Y. Tanaka, MD^*

Departments of *Anesthesiology and Physiology, Kyoto Prefectural University of Medicine, Kyoto; and Department of Anesthesiology, Yamanashi Medical University, Yamanashi, Japan

Address correspondence and reprint requests to Toshihiro Kasai, MD, Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kamigyoku, Kyoto 602-8566, Japan. Address e-mail to kasai{at}koto.kpu-m.ac.jp

Preoperative factors, such as age and body habitus, affect intraoperative hypothermia during general anesthesia. In a preliminary study, we developed a logistic model to retrospectively evaluate predictors of intraoperative hypothermia in patients who received major surgery. The following factors were selected to develop the model: Z = -15.014 + 0.097 x (Age) + 0.263 x (Height) - 0.323 x (Weight) - 0.055 x (Preoperative systolic blood pressure) - 0.121 x (Preoperative heart rate). By using this model, the probability of hypothermia can be estimated by applying the following for-mula: Probability = 1/(1 + e^-Z). If an estimated probability of hypothermia was >0.5, the sensibility of prediction was 81.5% and the specificity was 83%. In the second study, the model was applied prospectively to other patients, and the validity of the logistic model was evaluated. The core temperature showed a significant decrease in patients with a probability >0.7, who were predicted to be hypothermic, and their thermoregulatory vasoconstriction threshold also showed a significant decrease, compared with the patients with a probability 0.3, who were predicted to be normothermic. We concluded that intraoperative hypothermia could be predicted from preoperative characteristics such as age, height, weight, systolic blood pressure, and heart rate.

IMPLICATIONS: Increases in age and height and decreases in weight systolic blood pressure and heart rate are major preoperative risk factors of intraoperative hypothermia during major surgery.

This article has been cited by other articles:

				K. G.M. Moons, W. van Klei, and C. J. Kalkman Preoperative Risk Factors of Intraoperative Hypothermia in Major Surgery Under General Anesthesia Anesth. Analg., June 1, 2003; 96(6): 1843 - 1844. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999