Construction and validation of postoperative hypothermia prediction model for patients undergoing joint replacement surgery

Abstract

Aim To construct and validate a postoperative hypothermia prediction model for patients undergoing joint replacement surgery. Background Postoperative hypothermia is one of the harmful perioperative complications in patients undergoing joint replacement surgery. The previous studies mainly focused on intraoperative hypothermia prediction models. The prediction model for postoperative hypothermia in patients with joint replacement surgery was understudied. Design Cohort study. Methods We collected data from 503 participants undergoing joint replacement surgery in a tertiary hospital from January 2019 to December 2021. Of those, 404 cases were assigned to the modelling and 99 to the validation groups. Logistic regression was used to construct the model. The AUC was used to test the predictive effect of the model. Finally, 99 cases were used to verify the application effect of the model. A TRIPOD checklist was used to guide the reporting of this study. Results The factors entered into the prediction model were age, intraoperative hypothermia, BMI, heat preservation measures and platelet (PLT). The model was constructed as follows: Logit (P) = .537 + 3.669 × 1 (intraoperative hypothermia) + .030 × age − .289 × BMI + 2.857 × 1 (intraoperative insulation measures) + .003 × PLT. Hosmer–Lemeshow test, p = .608, the area under the receiver operating characteristic curve (AUC) was .861. The Youden index was .530, the sensitivity was .599 and the specificity was .93. The incidence of postoperative hypothermia in the modelling group was 42.93% (173/404), and that in the verification group was 43.43% (43/99), χ2 = .012, p = .912. The correct practical application rate was 87.88%. This model has a good application effect. Conclusion The current prediction model provided a reference for clinical screening of patients with high‐risk hypothermia after joint replacement surgery. Relevance to clinical practice Clinical nurses can use the developed prediction model to predict the occurrence of postoperative hypothermia and provide a reference for the preventive measure.

Factors Influencing the Occurrence of Intraoperative Hypothermia in Patients Undergoing General Anesthesia Intervention: A Study in a Tertiary Care Hospital

“…The set operating room temperature was an influential factor for hypothermia during general anesthesia intervention, which is consistent with the results of Li et al [ 23 ]. In clinical work, the temperature of an interventional operating room is usually set at 20°C to 23°C.…”

“…However, due to the use of anesthetic drugs and the complicated and time-consuming procedures of interventional surgery, intraoperative and postoperative hypothermia of patients can be caused, and the problem of intraoperative hypothermia of patients undergoing interventional surgery under general anesthesia requires urgent attention [ 9 , 10 ]. The current research on intraoperative hypothermia mostly focuses on open surgery, such as gastrointestinal surgery, orthopedics, thoracic obstetrics, and gynecology, and focuses on the application of thermal insulation equipment and nursing intervention, and there are no relevant studies on the current occurrence of hypothermia during interventional surgery and its influencing factors [ 11 – 13 ]. Therefore, this retrospective study included 184 patients to investigate the incidence and related factors of hypothermia during anesthesia in a single center in China from January to October 2023.…”

Intraoperative hypothermia in patients with laparoscopic surgery: Influencing factors and prevention strategies

“…Individuals in this category typically have a reduced body surface area relative to their mass, which can lead to a lower rate of heat dissipation through the body surface. This reduced heat dissipation is due to the fact that a lower BMI often correlates with less subcutaneous fat and a smaller body frame, both of which can limit the surface area available for heat exchange with the environment [ 24 , 25 ]. It is important for healthcare providers to consider these thermal differences when caring for patients with varying BMIs, as they can influence the patient's response to environmental temperature changes, their risk of developing hypothermia, and the effectiveness of certain medical interventions.…”

“…Intraoperative hypothermia is defined as a core body temperature below 36 °C during the period of anesthesia and surgery, a condition that can arise due to a multitude of factors [ 3 ]. It is reported that the incidence of hypothermia during operation is 40.13 %–75.06 % [ 4 , 5 ]. Intraoperative hypothermia can increase the incidence of perioperative adverse events, affect platelet aggregation, reduce the activity of coagulation factors, and increase the risk of bleeding [ 6 ].…”

Construction and validation of a risk prediction model for intraoperative hypothermia in elderly patients undergoing total hip arthroplasty

“…Based on a literature review, most joint replacement studies mixed THA and total knee arthroplasty (TKA) to construct risk prediction, which might affect the discrimination of risk factors and predictive values [ 26 , 27 ]. Moreover, the incidence rate of IOH after TKA was significantly lower than after THA [ 8 ].…”