Evaluation of a perioperative hypothermia prevention protocol in thoracic surgery with comparison to historical control

Perioperative hypothermia, defined as a temperature <36.0 °C negatively impacts surgical outcomes. The purpose of this study was to evaluate the efficacy of a perioperative hypothermia prevention protocol for thoracic surgery with the aim of reducing incidence and improving outcomes. A universal perioperative hypothermia prevention protocol was developed and implemented at one academic institution. All consecutive patients who underwent robotic-assisted (RATS) pulmonary resection were included in the interventional cohort. Patient temperature, and change in temperature, were measured at 5 time points and across 4 intervals. Outcomes included the occurrence of 30-day overall morbidity and any infectious complications. Interventional cohort patients were compared to a historical control. Of 417 patients, 104 (24.9%) were in the intervention and 313 (75.1%) were in the historic control group. Patients in the intervention group had significantly decreased risk-adjusted odds of experiencing a temperature <36.0 °C (odds ratio: 0.01 [95% confidence interval: 0.01-0.08]) or a temperature <35.0 °C (0.06 [0.02-0.21]). Patients who had a temperature <35.5 °C or < 35.0 °C had significantly increased risk-adjusted odds of overall morbidity (2.22 [1.18-4.17] and 2.17 [1.19-4.00]) and infectious morbidity (3.45 [1.52-8.33] and 3.23 [1.54-6.67]). Implementation of a thoracic perioperative hypothermia prevention protocol was associated with decreased risk-adjusted odds of hypothermia exposure with observed improvement in patient outcomes.