103 - Establishment and Validation of a Risk Prediction Model for Intraoperative Hypothermia in Patients Undergoing Laparoscopic Surgery
Clinical Issue: A lot of study have been done on intraoperative hypothermia, especially on the risk factors of hypothermia in thoracic and abdominal open surgery, thermal insulation nursing intervention, and so on. However, previous studies were focused on traditional direct vision surgery except the laparoscopic surgery. In recent years, the problem of hypothermia in laparoscopic surgery has gradually become a challenge in clinical practice with the development of laparoscopic surgery and the prolongation of operation time. In order to prevent the occurrence of hypothermia in laparoscopic surgery, our study aimed to bulid a risk prediction model of hypothermia in laparoscopic surgery based on the results of previous risk factors investigation.Description of Team: Ying Pu are OR head nurse of Shanghai General Hospital affiliated to Shanghai Jiaotong University, China.Preparation and Planning: Convenience sampling method was used to enroll all kinds of laparoscopic surgery patients in our hospital from January 2016 to December 2018 and 21 risk factors were screened for inclusion in the study. The sample size needed in this study was 394 cases.
Assessment: Our hospital is a tertiary general teaching hospital with 56 operating rooms. The annual operation volume is about 92000. There are 144 surgical nurses, all are college graduates or above.Implementation: A total of 396 patients that underwent laparoscopic surgery were enrolled. They were randomized into a modeling cohort of 264 patients and a validation cohort of 132 patients. Nasopharyngeal temperature was recorded from the beginning of anesthesia, the beginning of operation and every 15 minutes after the operation is started. The model was built by logistic regression, and the goodness of fit of the model was verified by Hosmer-Lemeshow test. The predictive validity of the model was evaluated by the area under the ROC curve (AUC).Outcome: The incidence of hypothermia in this group was 43.93%. The factors that ultimately entered the predictive model were basal body temperature, type of surgery, room temperature, and anesthesia time. H-L test P=0.123 > 0.05, the area under the ROC curve (AUC) was 0.791, while the Youden index was 0.867, with sensitivity 0.60 and specificity 0.867. The accuracy of the model was 79.54%.Implications for Perioperative Nursing: The predictive model in this study can predict the risk of intraoperative hypothermia in patients undergoing laparoscopic surgery, and thus can provide a reference for clinical screening of high-risk patients.