Dr Linda Mai1, A/Prof Dale Edgar1,2,3,4, Mr Glenn Boardman1, Dr. Kristine Owen1, Prof Fiona Wood1,2,3,4
1South Metropolitan Health Service, Murdoch, Australia, 2Institute for Health Research, Fremantle, Australia, 3Fiona Wood Foundation, Murdoch, Australia, 4State Adult Burns Unit, Murdoch, Australia
Background: Hypothermia is traditionally a state to be avoided in patients having surgery. The hypermetabolic response after a burn predisposes patients to hypothermia due to dysfunction of thermoregulation. The risk of hypothermia is compounded by general anaesthetic, exposure of wound areas and prolonged operation time. There are limited studies exploring the effects of perioperative hypothermia in the burns population. It is difficult to extrapolate results from patients without a hypermetabolic response due to a burn.
Objective: To determine whether there is an association between postoperative hypothermia and increased morbidity in burns patients.
Method: This was a retrospective analysis of patients admitted to the State Adult Burns Unit in Western Australia between 1st January 2015 to 28th February 2021 for surgical management of their burn. The postoperative temperature analysed was the first upon arrival in recovery. Normothermia was defined as 36.5-37.5°C, physiological hypothermia as 36.0-36.4°C and hypothermia as <36.0°C in accordance with guidelines. (National Institute for Health and Care Excellence, 2016) Data was modelled with a vectorized general linear model using a positive Poisson distribution.
Results: Among 844 patients, 368 (43.6%) were normothermic postoperatively. There were 397 (47.0%) patients with physiological hypothermia and 79 (9.4%) with hypothermia. Data modelling showed that hypothermia is associated with a shorter length of hospital stay (coefficient = -0.090, p=0.026). Patients with hypothermia had a lower probability of Hospital Acquired Complication (coefficient = -0.854, p=0.03).
Conclusion: In Western Australian acute burn patients, perioperative hypothermia was associated with reduced morbidity in patients with a burn injury.
Linda graduated from the University of Western Australia in 2018 and is working as a Resident Medical Officer at the South Metropolitan Health Service. Since her first year of medical school in 2015, Linda has been proactive in research focusing on optimising perioperative management of Burns patients. As Linda becomes more experienced as a medical practitioner, she looks forward to deepening her commitment to Burns research and further contributing to the advances in Burns care, especially during these everchanging times.