Perioperative hypothermia and its clinical consequences in geriatric patients undergoing abdominal surgery: a retrospective cohort study
摘要
Geriatric patients are highly susceptible to perioperative hypothermia due to diminished physiological reserve, comorbidities, and polypharmacy. Even mild temperature reductions may contribute to cardiac instability, delayed emergence from anesthesia, coagulopathy, increased blood loss, and elevated infection risk. This study aimed to evaluate the clinical impact of perioperative hypothermia in geriatric patients undergoing abdominal surgery.
Study designRetrospective observational study.
MethodsMedical records of 226 geriatric patients (ASA II–III) who underwent abdominal laparotomy between September 2018 and June 2022 at Marmara University were reviewed. Core temperature, anesthesia technique, operative duration, hemodynamic parameters, delayed emergence, postoperative intensive care unit (ICU) need, wound infection, mortality, and hospital length of stay were analyzed. Patients were classified as hypothermic (< 36.0 °C at any intraoperative measurement) or normothermic. Statistical analyses included Chi-square, Fisher’s exact, and Mann–Whitney U tests.
ResultsPerioperative hypothermia occurred in 195 patients (86.3%). Compared with normothermic patients, those who developed hypothermia had significantly higher rates of delayed emergence (p = 0.015), greater postoperative ICU requirement (p = 0.006), and longer hospitalization (p < 0.001). Hypothermic patients received higher doses of general anesthetic agents (p < 0.001). Heart rate was significantly lower at the 105th minute in the hypothermic group (p < 0.05), while instantaneous hypothermia was associated with higher baseline and 15-min heart rate and mean arterial pressure (p < 0.05). Other perioperative variables did not differ significantly.
ConclusionPerioperative hypothermia is highly prevalent among geriatric abdominal surgery patients and is associated with delayed emergence, increased ICU need, and prolonged hospitalization. These findings emphasize the need for routine temperature monitoring and active warming strategies to enhance perioperative safety in this vulnerable population.