Evaluation of a Perioperative Hypothermia Prevention Protocol in Thoracic Surgery with Comparison to Historical Control

Abstract Objectives 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. Methods A universal perioperative hypothermia prevention protocol was developed and implemented at 1 academic institution. All consecutive patients who underwent robotic-assisted thoracic surgery (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. Results 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]). Conclusions Implementation of a thoracic perioperative hypothermia prevention protocol was associated with decreased risk-adjusted odds of hypothermia exposure with observed improvement in patient outcomes. IRB Approval COMIRB #22-2045, Approved 01/09/2023.