INCIDENCE OF POSTOPERATIVE HYPOTHERMIA AND ASSOCIATED ANESTHESIA-RELATED RISK FACTORS IN PATIENTS UNDERGOING GENERAL SURGERY AT MARDAN MEDICAL COMPLEX

Abstract

Introduction: Postoperative hypothermia is a common yet often underrecognized complication of general anesthesia. It is associated with increased perioperative morbidity, including cardiovascular complications, coagulopathy, surgical site infections, delayed wound healing, and prolonged postoperative recovery. Despite its clinical significance, routine temperature monitoring and active warming measures are not consistently practiced in many resource-limited healthcare settings, including Pakistan. Consequently, surgical patients remain vulnerable to unintended perioperative heat loss and its adverse outcomes. This study was conducted to determine the incidence of postoperative hypothermia and identify anesthesia-related risk factors among patients undergoing general surgery at Mardan Medical Complex. Materials and Methods: A prospective observational study was conducted over a four-month period at Mardan Medical Complex. A total of 260 patients undergoing general surgical procedures under general anesthesia were enrolled. Core body temperature was measured using a calibrated tympanic infrared thermometer during the preoperative, intraoperative, and postoperative periods. Data regarding patient demographics, American Society of Anesthesiologists (ASA) physical status, type and magnitude of surgery, duration of anesthesia, volume of intravenous fluid administration, operating room temperature, and surgical urgency were collected. Statistical analysis was performed using SPSS version 24 to determine the incidence of postoperative hypothermia and its associated risk factors. Results: The overall incidence of postoperative hypothermia, defined as a core body temperature below 36°C, was 19.23% (50 out of 260 patients). Several factors were significantly associated with postoperative hypothermia. The highest incidence was observed among patients aged 50–60 years (52.0%) and female patients (66.0%). Preoperative hypothermia was present in 98.0% of affected patients. Major surgical procedures were associated with hypothermia in 96.0% of cases, while administration of more than 2 litres of intravenous fluids was observed in 98.0% of hypothermic patients. Prolonged anesthesia duration exceeding one hour was identified in 98.0% of cases, and operating room temperatures below 23°C were recorded in 96.0%. Additionally, ASA physical status class II or III was present in 80.0% of patients who developed postoperative hypothermia. Conclusion: Postoperative hypothermia affected approximately one in five patients undergoing general anesthesia at Mardan Medical Complex. Advanced age, female sex, preoperative hypothermia, major surgical procedures, prolonged anesthesia duration, administration of large volumes of intravenous fluids, lower operating room temperatures, and higher ASA physical status were identified as important risk factors. Routine perioperative temperature monitoring, implementation of active warming strategies, use of warmed intravenous fluids, and maintenance of appropriate operating room temperatures are recommended to reduce the incidence of postoperative hypothermia and improve patient outcomes.

Keywords: Postoperative hypothermia; General anesthesia; Perioperative temperature monitoring; Risk factors; General surgery; Operating room temperature; Intravenous fluids; ASA physical status; Patient warming; Pakistan.