Date Available

7-25-2018

Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Melanie Hardin-Pierce

Committee Member

Dr. Shelia Melander

Co-Director of Graduate Studies

Dr. Joseph Valentino

Abstract

PURPOSE: The purpose of this study is to determine whether intraoperative hypothermia exposure would be identified as an independent risk factor for surgical laryngectomy patients’ rate of postoperative complications within their surgical admission. The findings would help to justify the institution of “pre-warming” laryngectomy patients to prevent detrimental effects postoperatively.

METHODS: Retrospective chart review of 245 patients who had laryngectomies at the University of Kentucky from 2010-2017. Rate of complication and variables predictability of postoperative complications was evaluated.

RESULTS: In the sample, 157 patients developed complications. Complications included 35 transpharyngeal fistulas, 29 free flap failures, 43 hematomas, 50 wound infections/ wound breakdowns. Patients who were hypothermic had a significantly higher rate of complications than normothermic patients among all complications. Logistic regression identified intraoperative hypothermia as a significant predictor for the development of postoperative complications TPF (p=0.01) and SSI (p=0.012; odds ratio [OR], 2.80; 95% confidence interval, 1.02-12.66; OR, 2.44, CI, 0.78-7.58), and Chi-square analysis found significance among patients who experienced intraoperative hypothermia and who experienced both TPF and SSI.

CONCLUSION: Intraoperative hypothermia in head and neck surgery is positively correlated with postoperative complications in the development of complications, especially TPF and SSI. Maintaining normothermia through aggressive warming prior to intraoperative transport may decrease the incidence of perioperative morbidity for these patients.

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