Journal article
Perioperative Temperature Measurement Considerations Relevant to Reporting Requirements for National Quality Programs Using Data From Anesthesia Information Management Systems
Anesthesia and analgesia, Vol.126(2), pp.478-486
02/2018
DOI: 10.1213/ANE.0000000000002098
PMID: 28598914
Abstract
Perioperative hypothermia may increase the incidences of wound infection, blood loss, transfusion, and cardiac morbidity. US national quality programs for perioperative normothermia specify the presence of at least 1 "body temperature" ≥35.5°C during the interval from 30 minutes before to 15 minutes after the anesthesia end time. Using data from 4 academic hospitals, we evaluated timing and measurement considerations relevant to the current requirements to guide hospitals wishing to report perioperative temperature measures using electronic data sources. Anesthesia information management system databases from 4 hospitals were queried to obtain intraoperative temperatures and intervals to the anesthesia end time from discontinuation of temperature monitoring, end of surgery, and extubation. Inclusion criteria included age >16 years, use of a tracheal tube or supraglottic airway, and case duration ≥60 minutes. The end-of-case temperature was determined as the maximum intraoperative temperature recorded within 30 minutes before the anesthesia end time (ie, the temperature that would be used for reporting purposes). The fractions of cases with intervals >30 minutes between the last intraoperative temperature and the anesthesia end time were determined. Among the hospitals, averages (binned by quarters) of 34.5% to 59.5% of cases had intraoperative temperature monitoring discontinued >30 minutes before the anesthesia end time. Even if temperature measurement had been continued until extubation, averages of 5.9% to 20.8% of cases would have exceeded the allowed 30-minute window. Averages of 8.9% to 21.3% of cases had end-of-case intraoperative temperatures <35.5°C (ie, a quality measure failure). Because of timing considerations, a substantial fraction of cases would have been ineligible to use the end-of-case intraoperative temperature for national quality program reporting. Thus, retrieval of postanesthesia care unit temperatures would have been necessary. A substantive percentage of cases had end-of-case intraoperative temperatures below the 35.5°C threshold, also requiring postoperative measurement to determine whether the quality measure was satisfied. Institutions considering reporting national quality measures for perioperative normothermia should consider the technical and logistical issues identified to achieve a high level of compliance based on the specified regulatory language.
Details
- Title: Subtitle
- Perioperative Temperature Measurement Considerations Relevant to Reporting Requirements for National Quality Programs Using Data From Anesthesia Information Management Systems
- Creators
- Richard H Epstein - From the Department of Anesthesiology, Perioperative Medicine & Pain Management, Miller School of Medicine, University of Miami, Miami, FloridaFranklin Dexter - Department of Anesthesia, University of Iowa, Iowa City, IowaIra S Hofer - Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, CaliforniaLuis I Rodriguez - From the Department of Anesthesiology, Perioperative Medicine & Pain Management, Miller School of Medicine, University of Miami, Miami, FloridaEric S Schwenk - Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PennsylvaniaJoni M Maga - From the Department of Anesthesiology, Perioperative Medicine & Pain Management, Miller School of Medicine, University of Miami, Miami, FloridaBradley J Hindman - Department of Anesthesia, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Anesthesia and analgesia, Vol.126(2), pp.478-486
- Publisher
- United States
- DOI
- 10.1213/ANE.0000000000002098
- PMID
- 28598914
- ISSN
- 0003-2999
- eISSN
- 1526-7598
- Language
- English
- Date published
- 02/2018
- Academic Unit
- Health Management and Policy; Anesthesia
- Record Identifier
- 9983806374402771
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