[Development and validation of a risk prediction model for intraoperative hypothermia in patients undergoing thyroid
1Department of Operating Room, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.
Abstract:
Objective: To identify risk factors for intraoperative hypothermia in patients undergoing thyroid cancer surgery and to develop a risk prediction model. Methods: Clinical data of patients who underwent thyroid cancer surgery at the Affiliated Hospital of Hangzhou Normal University from January 2021 to June 2025 were retrospectively analyzed as the modeling cohort, and were subdivided into hypothermia and normothermia groups based on intraoperative body temperature. Logistic regression analysis and R software were used to construct the prediction model and nomogram. Data from patients treated at Hangzhou Traditional Chinese Medicine Hospital from January 2022 to June 2025 were collected for external validation. Results: The modeling cohort comprised 86 males and 252 females (age range, 27-77 years). The overall incidence of intraoperative hypothermia was 37.0%(125/338). Multivariate analysis identified age, body mass index (BMI), hypothyroidism, preoperative body temperature, anesthesia duration, preoperative active warming, and cervical lymph node dissection as independent risk factors (all P<0.05). The Hosmer-Lemeshow test yielded χ²=5.577 (P>0.05). The area under the receiver operating characteristic (ROC) curve was 0.911 for the modeling cohort (sensitivity 0.808, specificity 0.859), and 0.841 for the external validation cohort (n=101; sensitivity 0.871, specificity 0.700). The predicted probabilities demonstrated good concordance with observed incidences. Conclusion: The developed prediction model exhibits satisfactory goodness-of-fit, discriminative ability, and calibration, offering significant clinical value for identifying high-risk patients for intraoperative hypothermia during thyroid cancer surgery.