Incidence, causes, and effects of intraoperative hypothermia during elective oesophagectomy at a tertiary care centre- An observational study.

BACKGROUND AND AIMS: Patients undergoing oesophagectomies are at risk of intraoperative hypothermia. The study aims to determine the incidence of hypothermia during oesophagectomy surgeries.

METHODS

This observational bidirectional study evaluated 266 adult patients (175 retrospective and 91 prospective) undergoing elective oesophagectomy at a tertiary care centre between 2019 and 2022. Intraoperative core temperature was monitored hourly using a nasopharyngeal probe. Postoperative complications were recorded until discharge. Logistic regression analysis assessed the association between the incidence of hypothermia and perioperative variables. Those factors found significant in the simple logistic regression were then subjected to multiple logistic regression. A goodness-of-fit and sensitivity analysis was performed.

RESULTS

The incidence of intraoperative hypothermia (core temperature <36°C) was 90.6% [95% confidence interval (CI): 87, 94]. Nearly 60% of patients were found to be hypothermic before the surgery began. The incidence of clinically significant hypothermia (CSH) (core temperature <35°C) was 32.3% (95% CI: 30, 40). The perioperative factors significantly and independently associated with intraoperative hypothermia were preoperative significant weight loss [odds ratio (OR): 2.03, 95% CI: 1.17, 3.52, P = 0.012] and intraoperative requirement of vasopressors (OR: 2.76, 95% CI: 1.10, 6.93, P = 0.030). We found no association between intraoperative hypothermia and postoperative complications.

CONCLUSION

The study recorded a high incidence of intraoperative hypothermia during oesophagectomy surgeries. Hypothermia began in the preoperative period for nearly two-thirds of patients. Factors associated with CSH included preoperative significant weight loss and the intraoperative need for vasopressors. No significant association was found with postoperative complications and discharge.