title: Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey.
abstract: OBJECTIVE
  Inadvertent intraoperative hypothermia (core temperature <360 C) is a recognized risk in surgery and has adverse consequences. However, no data about this complication in China are available. Our study aimed to determine the incidence of inadvertent intraoperative hypothermia and its associated risk factors in a sample of Chinese patients.
  
  
  METHODS
  We conducted a regional cross-sectional survey in Beijing from August through December, 2013. Eight hundred thirty patients who underwent various operations under general anesthesia were randomly selected from 24 hospitals through a multistage probability sampling. Multivariate logistic regression analyses were applied to explore the risk factors of developing hypothermia.
  
  
  RESULTS
  The overall incidence of intraoperative hypothermia was high, 39.9%. All patients were warmed passively with surgical sheets or cotton blankets, whereas only 10.7% of patients received active warming with space heaters or electric blankets. Pre-warmed intravenous fluid were administered to 16.9% of patients, and 34.6% of patients had irrigation of wounds with pre-warmed fluid. Active warming (OR = 0.46, 95% CI 0.26-0.81), overweight or obesity (OR = 0.39, 95% CI 0.28-0.56), high baseline core temperature before anesthesia (OR = 0.08, 95% CI 0.04-0.13), and high ambient temperature (OR = 0.89, 95% CI 0.79-0.98) were significant protective factors for hypothermia. In contrast, major-plus operations (OR = 2.00, 95% CI 1.32-3.04), duration of anesthesia (1-2 h) (OR = 3.23, 95% CI 2.19-4.78) and >2 h (OR = 3.44, 95% CI 1.90-6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45-4.12) significantly increased the risk of hypothermia.
  
  
  CONCLUSIONS
  The incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids.
authors.affiliation: Peking Union Medical College Hospital, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yi
authors.affiliation: 3M China R&D Center, Shanghai, China.
authors.forename: Ziyong
authors.initials: Z
authors.lastname: Xiang
authors.affiliation: Plastic Surgery Hospital and Institute, CAMS, PUMC, Beijing, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Deng
authors.affiliation: Tsinghua University Yuquan Hospital, Beijing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Fan
authors.affiliation: Beijing Chuiyangliu Hospital, Beijing, China.
authors.forename: Runqiao
authors.initials: R
authors.lastname: Fu
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing, China.
authors.forename: Wanming
authors.initials: W
authors.lastname: Geng
authors.affiliation: Miyunxian Hospital, Beijing, China.
authors.forename: Ruihong
authors.initials: R
authors.lastname: Guo
authors.affiliation: Peking University Shougang Hospital, Beijing, China.
authors.forename: Nong
authors.initials: N
authors.lastname: He
authors.affiliation: China-Japan Friendship Hospital, Beijing, China.
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
authors.affiliation: China Meitan General Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.affiliation: Peking University Third Hospital, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Beijing Tongren Hospital Capital Medical University, Beijing, China.
authors.forename: Tianzuo
authors.initials: T
authors.lastname: Li
authors.affiliation: Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Tian
authors.affiliation: Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Geng
authors.initials: G
authors.lastname: Wang
authors.affiliation: Haidian Maternal & Child Health Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Xuanwu Hospital Capital Medical University, Beijing, China.
authors.forename: Tianlong
authors.initials: T
authors.lastname: Wang
authors.affiliation: Beijing Chao-Yang Hospital, Beijing, China.
authors.forename: Anshi
authors.initials: A
authors.lastname: Wu
authors.affiliation: Luhe Teaching Hospital of the Capital Medical University, Beijing, China.
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.affiliation: Air Force General Hospital, PLA, Beijing, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Xue
authors.affiliation: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
authors.forename: Mingjun
authors.initials: M
authors.lastname: Xu
authors.affiliation: Air Force General Hospital, PLA, Beijing, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Yang
authors.affiliation: Central Hospital of China Aerospace Corporation, Beijing, China.
authors.forename: Zhanmin
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Beijing Rectum Hospital, Beijing, China.
authors.forename: Jianhu
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Beijing Shi Jing Shan Hospital, Beijing, China.
authors.forename: Qiuhua
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Beijing Pinggu Hospital, Beijing, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Beijing Hospital of the Ministry of Health, Beijing, China.
authors.forename: Mingzhang
authors.initials: M
authors.lastname: Zuo
authors.affiliation: 3M China R&D Center, Shanghai, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Pan
authors.affiliation: 3M China R&D Center, Shanghai, China.
authors.forename: Lujing
authors.initials: L
authors.lastname: Zhan
authors.affiliation: 3M China R&D Center, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.affiliation: Peking Union Medical College Hospital, Beijing, China.
authors.forename: Yuguang
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D000068476:Beijing / Q000453:epidemiology; D001831:Body Temperature; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology* / Q000209:etiology*; D015994:Incidence; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors