Intraoperative hypothermia during laparoscopic radical prostatectomy: incidence, timing, and associated preoperative factors—a retrospective cohort study

Abstract Background: Intraoperative hypothermia remains a concern during laparoscopic radical prostatectomy (LRP), but its timing and associated preoperative factors are unclear. We investigated the occurrence, timing, and preoperative factors associated with intraoperative hypothermia during LRP. Methods: This single-center retrospective cohort study included 381 consecutive patients undergoing elective LRP between January 2022 and June 2024. Hypothermia was defined as any nasopharyngeal core temperature <36.0 °C, and early hypothermia as first detection within 2 h after anesthesia induction. Variables with P<0.10 in univariable analyses were entered into multivariable logistic regression. Early hypothermia was examined in an exploratory analysis. Results: Overall, 103 patients (27.0%) developed intraoperative hypothermia, and 90 (87.4%) were first identified within 2 h. Greater preoperatively estimated blood loss (adjusted odds ratio [aOR] per 50 mL, 1.32; 95% confidence interval [CI], 1.05–1.66), lower body mass index (aOR per 1 kg/m², 0.88; 95% CI, 0.81–0.96), and C-reactive protein >5 mg/L (aOR, 5.73; 95% CI, 2.86–11.46) remained associated with overall hypothermia after adjustment. Baseline temperature was not significantly associated with the overall outcome (P=0.053). In the exploratory analysis, these three factors remained associated with early hypothermia, and higher baseline temperature was additionally associated with lower odds of this outcome (aOR per 0.1 °C, 0.913; 95% CI, 0.835–0.998). Conclusions: Approximately one-quarter of patients developed intraoperative hypothermia, with most cases detected within 2 h after anesthesia induction. Routinely available preoperative factors were associated with hypothermia and may help identify patients requiring closer early temperature surveillance. Prospective multicenter studies are needed to confirm these findings.