Abstract
INTRODUCTION: Postoperative hypothermia is a common complication following abdominal surgery under general anesthesia. It is associated with delayed recovery, increased postoperative complications, and prolonged hospitalization. However, comprehensive research on its risk factors remains limited. This study aimed to identify key perioperative factors associated with postoperative hypothermia to guide prevention strategies. METHODS: This retrospective cohort study included 256 patients who underwent abdominal surgery under general anesthesia. Patients were categorized into a hypothermia group (core temperature < 36°C, n = 66) and a normothermia group (n = 190) based on postoperative core temperature measured upon PACU admission. Demographic data, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, anesthesia details, surgical duration, ventilation time, warming measures, baseline temperature, blood loss, and postoperative surgical site infection were collected. The hypothermia group was further divided into mild (≤ 2 episodes) and severe (> 2 episodes) subgroups based on hypothermia frequency within 24 hours postoperatively. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. RESULTS: Age, BMI, duration of anesthesia and surgery, absence of prewarming, blood loss, transfusion, and surgical site infection were significantly associated with postoperative hypothermia in univariate analysis. Multivariate analysis confirmed that BMI, lack of prewarming, and blood loss were independent predictors of postoperative hypothermia. CONCLUSION: Postoperative hypothermia after abdominal surgery is influenced by multiple perioperative factors. Strategies targeting modifiable risk factors-particularly prewarming, temperature monitoring, and optimization of intraoperative blood loss-may reduce hypothermia incidence and support improved postoperative recovery.