Characteristics and Risk Factors of Intraoperative Hypothermia in Adults - A Multicenter Prospective Observational Clinical Study

Q: What was the main objective of the multicenter study?

To describe the occurrence patterns of intraoperative hypothermia in adults and identify its major independent risk factors for evidence-based early risk assessment and intervention.

Q: How was intraoperative hypothermia defined and measured?

It was defined as a decrease in core body temperature below 36.0 °C during surgery, assessed via standardized continuous intraoperative temperature monitoring.

Q: What was the overall incidence and where did hypothermia occur most frequently?

The overall incidence was 23.82%. Hypothermia was most frequent with a preoperative baseline core temperature ≤ 35.9 °C (85.93%), with hand surgery showing the highest incidence (51.35%) and upper-extremity procedures the highest rate (35.00%).

Sep 30, 2026

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Intraoperative hypothermia is a frequent perioperative complication in adults. A large-scale multicenter prospective observational study quantified its occurrence patterns and determined independent risk factors to enable early evidence-based risk assessment and targeted intervention. Among 4516 surgical patients from 12 tertiary general hospitals, core body temperature was continuously monitored using standardized methods. Multivariable logistic regression identified multiple modifiable factors associated with intraoperative hypothermia, and the overall incidence was 23.82%.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusions

1. Introduction

Definition and clinical significance

Limitations of existing evidence

Study rationale and aim

Article Characteristics and Risk Factors of Intraoperative Hypothermia in Adults: A Multicenter Prospective Observational Clinical Study Hanqing Zhang 1,2, Xinglian Gao 1,*, Wen Ke 1, Zengyan Wang 1, Qiong Ma 1, Wenjing Yu 1, Juanjuan Hu 1 and on behalf of the Intraoperative Hypothermia Investigators (12-Center Consortium)† Academic Editors: Cyrus Motamed and Hirofumi Noguchi Received: 13 November 2025 Revised: 14 December 2025 Accepted: 18 December 2025 Published: 20 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China 2 School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China * Correspondence: [sssgxl@sina.com](sssgxl@sina.com) † Group Authorship Note: The Intraoperative Hypothermia Investigators (12-center Consortium) includes researchers from 12 tertiary general hospitals across China who contributed to patient enrollment and data collection. The full list of collaborators and affiliations is provided in Appendix A. Abstract Objective: Intraoperative hypothermia is a common perioperative complication. This large-scale, multicenter, prospective clinical study aimed to delineate the occurrence patterns of intraoperative hypothermia in adults and to identify its major independent risk factors, thereby providing evidence-based support for early clinical risk assessment and intervention. Methods: This study adopted a multicenter, prospective, observational design. Eligible participants were screened based on predefined inclusion and exclusion criteria, and a total of 4516 surgical patients (≥18 years) from 12 tertiary general hospitals across China were ultimately enrolled. Core body temperature was continuously monitored intraoperatively using standardized methods. Data on demographic characteristics, surgical and anesthesia-related parameters, and perioperative temperature management interventions were collected. Patients were stratified into groups according to the presence or absence of hypothermia (core temperature <36.0 ◦ C) . Univariate analyses were first conducted to identify associated factors, followed by multivariable logistic regression to determine factors independently associated with intraoperative hypothermia. Results: The overall incidence of intraoperative hypothermia among surgical patients was 23.82% . Hypothermia occurred most frequently in patients with a preoperative baseline core temperature ≤ 35.9 ◦ C (85.93%) . Among surgical specialties, hand surgery had the highest incidence of hypothermia (51.35%), and among surgical sites, procedures involving the upper extremities showed the highest rate (35.00%) . Multivariable logistic regression analysis identified the following as independent risk factors for intraoperative hypothermia: Type of anesthesia (OR = 1.743, 95% CI: 0.834–3.644), ASA classification (OR = 1.408, 95% CI: 1.197–1.657), Surgical approach (OR = 0.735, 95% CI: 0.577–0.936), Skin disinfection site (OR = 2.024, 95% CI: 1.534–2.670), Volume of cold intravenous fluids infused (mL) (OR = 1.365, 95% CI: 1.140–1.633), Volume of transfused blood (U) (OR = 1.116, 95% CI: 0.807–1.542), Intraoperative blood loss (mL)(OR = 1.252, 95% CI: 0.892–1.756), and Duration of surgery (hours) (OR = 2.014, 95% CI: 1.683–2.411) . Conclusions: The incidence of intraoperative hypothermia in adults was relatively high at 23.82% and was observed to be associated with multiple modifiable perioperative factors. These findings support the need to strengthen risk assessment and implement individualized temperature management strategies in clinical practice, with the goal of reducing the risk of intraoperative hypothermia and improving perioperative safety and outcomes.

FAQs

What was the main objective of the multicenter study?

To describe the occurrence patterns of intraoperative hypothermia in adults and identify its major independent risk factors for evidence-based early risk assessment and intervention.

How was intraoperative hypothermia defined and measured?

It was defined as a decrease in core body temperature below 36.0 °C during surgery, assessed via standardized continuous intraoperative temperature monitoring.

What was the overall incidence and where did hypothermia occur most frequently?

The overall incidence was 23.82%. Hypothermia was most frequent with a preoperative baseline core temperature ≤ 35.9 °C (85.93%), with hand surgery showing the highest incidence (51.35%) and upper-extremity procedures the highest rate (35.00%).

Sep 30, 2026

Upload by Indoniesian Boy