The relationship between preoperative temperature and intraoperative hypothermia in patients undergoing robotic colorectal cancer surgery.

Intraoperative hypothermia (IOH) is a prevalent perioperative complication.Although the use of robotic surgery in addressing colorectal cancer has seen a notable upward trend in recent clinical practice, its particularity increases the risk of IOH. Therefore, it is particularly important to study the relationship between robotic colorectal cancer surgery (RCRC) and IOH. We retrospectively collected data from patients who underwent RCRC at Jiangsu North People's Hospital from October 2019 to February 2025. Data regarding intraoperative core temperature and potential influencing factors was collected to probe into the risk factors of IOH in patients undergoing RCRC surgery. Statistical analyses were performed using weighted logistic regression and linear models, with restricted cubic splines (RCS) adopted to detect possible non-linear associations, and subgroup analyses carried out as well. A total of 452 patients were included; IOH was observed in 218 patients (incidence rate, 0.48). Results from univariate and multivariate analyses showed that higher BMI and preoperative body temperature were protective factors against IOH (OR = 0.834, 95% CI: 0.657-0.952, P = 0.012; OR = 0.632, 95% CI: 0.432-0.858, P = 0.018). ASA physical status and operative time were risk factors for IOH (OR = 5.359, 95% CI: 1.680-9.378, P = 0.044; OR = 2.132, 95% CI: 1.123-6.230, P = 0.038). Upon analyzing preoperative body temperature through quartiles, a significant negative correlation was identified between preoperative body temperature and IOH in Quartile 4 (36.6-37.5 ℃). The odds ratio (OR) values were 0.80 (95% CI: 0.65-0.97), 0.64 ((95% CI: 0.53-0.83), and 0.69 (95% CI: 0.55-0.85) for Models 1, 2, and 3, respectively, with corresponding P-values of 0.024, 0.028, and 0.018. RCS highlighted a significant negative non-linear association (nonlinear test P = 0.017, consistent with the described P = 0.019). Below 36.5 ℃, for every 0.1 ℃ decrease, the risk of IOH increased by 13.5% (OR = 1.365, 95% CI: 1.021-1.430). No significant interaction phenomena were detected in any of the subgroups. In the present study focusing on patients who underwent RCRC surgery, there was an L-shaped non-linear relationship between preoperative body temperature and IOH, with the inflection point approaching 36.5 ℃. The integration of RCS and subgroup analyses enhances the depth of our findings, providing valuable insights for preventing perioperative IOH in patients undergoing RCRC.