Incidence and Risk Factors of Peri-operative Hypothermia in Adults Undergoing Cancer Surgery – A Quality Improvement Audit

Background and Aims: Inadvertent hypothermia is a silent and often missed factor having many adverse peri-operative consequences affecting the cardiovascular, haematological, coagulation and immunological systems. The aim of this study was to see the incidence of peri-operative hypothermia and its associated risk factors. Methods: This prospective observational study was conducted in adults undergoing elective oncosurgical procedures in a tertiary cancer centre. Data on demographics, temperature monitoring, measures to prevent hypothermia, procedure details and adverse events were collected and analysed to identify independent factors associated with hypothermia. A core temperature of <35°C and a skin temperature of <34°C were considered hypothermia. P <0.05 was considered statistically significant. Results: Data were collected from 450 eligible patients over a 6-month period. The incidence of intra-operative hypothermia was 22% and post-operative hypothermia was 8.7%. Hypothermia was associated with general anaesthesia and cavity surgeries for a longer duration of time. Patients with post-operative surgical complications were 91% more likely to have peri-operative hypothermia as compared to patients without complications. Patients undergoing cavity surgery were 2.3 times more likely to have intra-operative hypothermia as compared to those undergoing surface surgery cases. Conclusion: We found that complications related to peri-operative hypothermia were due to a lack of pre-operative warming and post-induction delays related to positioning and scrubbing. In addition, we could use extra active warming measures, such as under-body warmers, intra-operatively.