Evaluation of Risk Factors and Postoperative Outcomes in Surgical Laryngectomies with Intraoperative Hypothermia
Year of Publication
Doctor of Nursing Practice
Dr. Melanie Hardin-Pierce
Dr. Joseph Valentino
Dr. Shelia Melander
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.
Carter, Kristen V., "Evaluation of Risk Factors and Postoperative Outcomes in Surgical Laryngectomies with Intraoperative Hypothermia" (2018). DNP Projects. 211.
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