机构：[1]Department of Anesthesiology, Chinese Academy of Medical Sciences & Peking Union MedicalCollege Hospital, Beijing, China,[2]Department of Anesthesiology, the Second People's Hospital of Wuhu,Wuhu, Anhui, China,[3]Department of Anesthesiology, Zhujiang Hospital of Southern Medical University,Guangzhou, Guangdong, China,南方医科大学珠江医院[4]Department of Anesthesiology, the Second Affiliated Hospital of KunmingMedical University, Kunming, Yunnan, China,[5]Department of Anesthesiology, Quanzhou Women's andChildren's Hospital, Quanzhou, Fujian, China,[6]Department of Anesthesiology, Renmin Hospital of WuhanUniversity, Wuhan, Hubei, China,[7]Department of Anesthesiology, Lanzhou University Second Hospital,Lanzhou, Ganshu, China,[8]Department of Anesthesiology, Nanjing Drum Tower Hospital, Nanjing UniversityMedical School, Nanjing, Jiangsu, China,[9]Department of Anesthesiology, the Affiliated Hospital of InnerMongolia Medical University, Inner Mongolia, China,[10]Department of Anesthesiology, the Second AffiliatedHospital of Nanchang University, Nanchang, Jiangxi, China,[11]Department of Anesthesiology, the FirstAffiliated Hospital of Anhui Medical University, Hefei, Anhui, China,[12]Department of Anesthesiology,Tianjin Medical University General Hospital, Tianjin, China,[13]Department of Anesthesiology, FujianProvincial Hospital, Fuzhou, Fujian, China,[14]Department of Anesthesiology, the Fourth Hospital ofHebei Medical University, Shijiazhuang, Hebei, China,河北医科大学第四医院[15]Department of Anesthesiology, Haikou People'sHospital, Haikou, Hainan, China,[16]Department of Anesthesiology, the Third Hospital of Hebei MedicalUniversity, Shijiazhuang, Hebei, China,[17]Departement of Anesthesiology, Anhui Provincial Hospital, Hefei,Anhui, China,[18]Department of Anesthesiology, the First Affiliated Hospital of Wannan Medical College,Wuhu, Anhui, China,[19]Department of Anesthesiology, Ningbo No.2 Hospital, Ningbo, Zhejing, China,[20]Department of Anesthesiology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai,China,[21]Department of Anesthesiology, the Second Hospital of Dalian Medical University, Dalian, Liaoning,China,[22]Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang,China,[23]Department of Anesthesiology, the First Affiliated Hospital of Chongqing Third Military MedicalUniversity, Chongqing, China,[24]Department of Anesthesiology, Tianjin First Central Hospital, Tianjin,China,[25]Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China,[26]Department of Anesthesiology, Nanfang Hospital, Guangzhou, Guangdong, China,[27]Department ofAnesthesiology, the People's Hospital of Sanya, Sanya, Hainan, China,[28]Department of Anesthesiology,Sino-Japanese Union Hospital of Jilin University, Changchun, Jilin, China,吉林大学中日联谊医院[29]3M R&D Center, Shanghai,China
Background/Objective Inadvertent intraoperative hypothermia (core temperature <36 degrees C) is a frequently preventable complication with several adverse consequences. Our study aimed to determine the overall incidence of inadvertent intraoperative hypothermia and its risk factors associated with clinical outcomes in this national survey in China. Methods We conducted a national cross-sectional study with 30 days postoperative follow-up from November 2014 through August 2015. A total of 3132 eligible patients underwent general anesthesia were randomly selected from 28 hospitals in the nationwide of China. Results The overall incidence of intraoperative hypothermia was as high as 44.3%, in which cumulative incidence rates of hypothermia being 17.8%, 36.2%, 42.5% and 44.1% within 1 h, 2 h, 3 h and 4 h respectively following induction of anesthesia. All patients were warmed passively by covering of surgical draping, sheets or cotton blankets, whereas only 14.2% of patients received active warming with space heaters or electric heater or electronic blankets. Compared to normothermic patients, patients with hypothermia is associated with more postoperative ICU admit, longer PACU and more postoperative hospital days, but no difference in surgical site infection (SSI) rates or 30-day mortality. Several factors were shown to be associated with decreased risk of hypothermia. They are active warming (OR = 0.46, 95% CI 0.26-0.81), BMI >= 25 (OR = 0.54, 95% CI 0.45-0.65), higher baseline core temperature (OR = 0.04, 95% CI 0.03-0.06), and higher ambient temperature (OR = 0.83, 95% CI 0.78-0.88). Risk factors associated with an increased risk of hypothermia included major-plus surgery (OR = 1.49, 95% CI 1.23-1.79), and long anesthesia (>2 h) (OR = 2.60, 95% CI 2.09-3.24). Conclusions The incidence of intraoperative hypothermia in China is high, and the rate of active warming of patients during operation is low. Hypothermia is associated with more postoperative shivering, increased ICU admissions, and longer postoperative hospital days.
基金：
China National Health and Planned Parenthood Committee Health Quality Improvement Award [201402017]; China National Nature Science FoundationNational Natural Science Foundation of China [31070930]; unrestricted research grant from 3M China [MDI0091]
第一作者机构：[1]Department of Anesthesiology, Chinese Academy of Medical Sciences & Peking Union MedicalCollege Hospital, Beijing, China,
通讯作者：
推荐引用方式(GB/T 7714)：
Jie Yi,Yongjing Lei,Shiyuan Xu,et al.Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China[J].PLOS ONE.2017,12(6):doi:10.1371/journal.pone.0177221.
APA：
Jie Yi,Yongjing Lei,Shiyuan Xu,Yongyu Si,Shiyang Li...&Yuguang Huang.(2017).Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China.PLOS ONE,12,(6)
MLA：
Jie Yi,et al."Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China".PLOS ONE 12..6(2017)
