Independent risk factors for postoperative shivering

Area of Science:

• Anesthesiology
• Perioperative Medicine
• Clinical Risk Assessment

Background:

• Postoperative shivering (PAS) presents significant patient discomfort and potential complications.
• Identifying reliable predictors for PAS is crucial for effective prophylactic management.
• Current understanding of independent risk factors for PAS requires further elucidation.

Purpose of the Study:

• To identify independent risk factors associated with postoperative shivering (PAS) following general anesthesia.
• To develop and validate a predictive risk score for PAS incidence.
• To assess the clinical utility of the developed risk score in predicting PAS.

Main Methods:

• Observational trial involving 1340 consecutive patients undergoing general anesthesia.
• Data collection included patient demographics, surgical factors, core/peripheral temperatures, and shivering signs.
• Logistic regression analysis was used to identify risk factors and formulate a risk score, validated using ROC-curve analysis.

Main Results:

• The overall incidence of PAS was 11.6%.
• Independent risk factors identified were young age (most significant), endoprosthetic surgery, and core hypothermia.
• The developed risk score demonstrated reasonable predictive discrimination (AUC = 0.69) and good calibration (R² = 0.82).

Conclusions:

• Postoperative shivering can be predicted with acceptable accuracy using a model based on identified risk factors.
• The validated risk score serves as a potential clinical tool for rational administration of prophylactic antishivering medications.
• This predictive model aids clinicians in optimizing patient care and preventing PAS complications.