Perioperative Outcomes Associated with Intraoperative Hypothermia in Pediatric Patients with Preserved Functional Capacity Undergoing Anesthesia: A Multivariate Analysis

Background/Objectives: Few studies have investigated the perioperative adverse events following intraoperative hypothermia in pediatric patients with preserved functional capacity. We aimed to assess associations between intraoperative hypothermia and adverse outcomes in pediatric patients undergoing anesthesia. Methods: This retrospective cohort study included children under 12 years of age who underwent anesthesia in 2020 at Songklanagarind Hospital, Thailand. Intraoperative hypothermia was defined as the occurrence of >1 episode of a core temperature drop to <36 °C during anesthesia. Perioperative data were extracted from the hospital information system and analyzed to identify adverse outcomes. Children with an American Society of Anesthesiologists (ASA) physical status of 4–5 were excluded to ensure only those with preserved functional capacity before surgery were included. Multivariate regression modeling was used to evaluate associations between hypothermia and adverse outcomes after adjusting for potential confounders. Odds ratios (ORs) or beta coefficients (β) with 95% confidence intervals (CIs) were determined. Results: Among the 892 patients, 169 (19%) experienced intraoperative hypothermia. Intraoperative hypothermia was significantly associated with postoperative ventilator requirements (p<0.001), postoperative intensive care unit (ICU) admission (p<0.001), longer ventilator requirements (p<0.001), and prolonged ICU stays (p<0.001) and hospitalization periods (p<0.001). The multivariate analysis demonstrated that intraoperative hypothermia was only associated with prolonged ICU stays (β 1.2 [0.67,1.73] days) and hospitalization periods (β 1.42 [0.78, 1.71] days). Conclusions: Intraoperative hypothermia was associated with adverse outcomes in children with preserved functional capacity undergoing anesthesia, suggesting hospital policies should be modified to ensure vigorous perioperative temperature management to mitigate these outcomes.