Abstract
BACKGROUND: Intraoperative hypothermia is a prevalent complication that may significant clinical and economic burdens. Previous risk assessment models have demonstrated limitations in accurately predicting intraoperative hypothermia, particularly in diverse surgical populations. This study aims to develop and validate a model in adult surgical patients to improve outcomes. METHODS: This retrospective cohort study utilized data extracted from electronic medical records and anaesthesia information management systems between June 2022 and August 2023. The analysis included information of 3,405 adult surgical patients from three independent centres in China who underwent elective surgical procedures with body temperature monitoring. Intraoperative hypothermia was defined as a core temperature below 36 °C during surgery. The Least Absolute Shrinkage and Selection Operator (LASSO) regression employed to select optimal features and multivariate logistic regression was used to identify independent predictors of intraoperative hypothermia and then built the risk assessment model. We further evaluated the discriminative ability, calibration curves, and clinical utility of the predictive model. RESULTS: The total incidences of intraoperative hypothermia in adult surgical patients were 42.5%. The predictors in the intraoperative hypothermia model included: age, BMI, baseline HR, baseline temperature, minimally invasive surgery, smoking, previous surgery and serum creatine level. In the training cohort, the model demonstrated strong discriminatory ability, with C-index values of 0.721 (95% CI 0.697-0.744). Internal and external validation further confirmed the model's robustness and generalizability. CONCLUSION: These findings suggest that our model may help us more accurately identify patients at risk of intraoperative hypothermia. TRIAL REGISTRATION: China Clinical Trial Registration Center (ChiCTR2300071859), Date registered May/26/2023.