Evidence

Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs

In Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs, Mahoney concludes that there is a significant difference in outcomes between normothermic patients and mildly hypothermic patients. In addition to examining the outcomes between groups, Mahoney also analyzes the costs associated with the respective outcomes. Costs are shown to be significantly higher in the mildly hypothermic patients. Mahoney further indicates that it is more costly to treat the outcomes associated with mild patient hypothermia than to prevent them.

C.B. Mahoney, J. Odom. Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs. AANA J. 1999; 67(2):155-63.

Mild intraoperative hypothermia prolongs postanesthetic recovery

Post-operatively patients must meet certain criteria before being released from the post anesthesia care unit (PACU). In Mild intraoperative hypothermia prolongs postanesthetic recovery, Lenhardt et al. establish that there is a significant difference in time spent in the PACU between patients who are considered normothermic and those considered to be mildly hypothermic. Interestingly, even when a minimum core temperature pf 36°C was not required as a criterion for discharge, hypothermic patients stayed longer in the PACU. A longer stay in the PACU has far reaching effects, namely on the bottom line due to costs associated with PACU time.

R. Lenhardt, E. Marker, V. Goll, H. Tschernich, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology 1997; 87(6):1318-23.

Financial Impact of Surgical Site Infections on Hospitals: The Hospital Management Perspective

The negative impacts of surgical site infections (SSI) are well known. There are penalties associated with readmission rates from SSIs from Centers for Medicare and Medicaid (CMS). There are impacts on patients lives and associated health risks. In Financial Impact of Surgical Site Infections on Hospitals: The Hospital Management Perspective, Shepard looks at the financial impact of SSIs from the hospital management perspective. The article finds that the direct cost and opportunity cost of treating SSIs can potentially cost hospital millions of dollars each year.

J. Shepard, W. Ward, A. Milstone, et al. Financial Impact of Surgical Site Infections on Hospitals: The Hospital Management Perspective. Jama Surgery 2013; 148(10):907-914.

Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization

Inadvertent mild hypothermia poses a number of risks to patients in addition to hurting hospitals both operationally and financially. In his article, Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group, Kurz determines that hypothermic patients have an increased length of hospital stay and are at higher risk of infection. Not only does this article directly link hypothermia to increased risk of infection, it demonstrates the negative financial and operational impacts to a hospital.

A. Kurz, D.I. Sessler, R. Lenhardt. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996; 334(19):1209-15