Analysis of the risk factors of hypothermia during emergency treatment for acute intestinal obstruction and establishment of prediction model

Objective To investigate the risk factors of hypothermia during emergency treatment for acute intestinal obstruction, and establish a risk model.

Methods The clinical data of 200 patients treated with emergency treatment for acute intestinal obstruction were retrospectively analyzed.According to whether hypothermia occurred during the operation, the patients were divided into the hypothermia group(68 cases) and non-hypothermia group(132 cases).The clinical baseline data(including age, sex and BMI), operating room monitoring indicators(including operation time, intraoperative lavage volume, intraoperative blood loss and whether composite insulation measures) and laboratory indicators(including albumin and hemoglobin levels) were collected.The independent sample t test and χ² test were used for single factor analysis.Binary logistic regression was used to analyze the independent risk factors of intraoperative hypothermia in patients with acute ileus, and ROC curve was used to predict the independent risk factors.

Results There was no statistical significance in the age, sex, intraoperative blood loss, albumin and hemoglobin between the hypothermia group and non-hypothermia group(P>0.05).The differences of the BMI, operation time, intraoperative lavage volume and composite insulation measures between the hypothermia group and non-hypothermia group were statistically significant(P<0.05).The results of binary logistic regression analysis showed that the operation time more than 2 h, intraoperative lavage volume more than 4 000 mL, no-taking composite insulation measure and BMI less than or equal to 23 kg/m² were the independent risk factors of intraoperative hypothermia in patients with ileus(P<0.01).Based on binary logistic regression analysis, the Hosmer-Lemeshow test of prediction model showed P=0.161, whcih indicated the fit was good.The ROC curve was used to predict the sensitivity and specificity of actual hypothermia.The area under the curve was 0.916, the optimal cut-off value was 0.680, and the sensitivity and specificity were 0.794 and 0.886, respectively.

Conclusions The operation time, intraoperative lavage volume, composite insulation measures and BMI are related to the intraoperative hypothermia in patients with acute ileus.Establishing a risk prediction model can better evaluate the risk of intraoperative hypothermia in patients with acute ileus, and provide reference in the early monitoring and prevention of disease for clinical medical staff.