Thermal Regulation in Medicine Open access Peer reviewed

Hypothermia in the intensive care unit after surgery: a registry based retrospective cohort study

Jeremy Weiss, Matthew Durie, Tamishta Hensman, Tess Evans and 1 more

BJA Open | Aug 13, 2026

Abstract

Abstract

Background Hypothermia is common in patients admitted to the ICU after surgery; however, its relationship with postoperative outcomes has not been fully explored. This study investigates the association between postoperative hypothermia in the ICU and patient mortality. Methods Retrospective cohort study using the Australian and New Zealand Intensive Care Society adult patient database. Postoperative noncardiac surgical ICU admissions between 2018 and 2023 were included. Hypothermia was defined as temperature <36°C. The lowest temperature recorded within the first 24 hours of ICU admission was used. The primary outcome was in hospital mortality with secondary outcomes including ICU mortality rate, length of stay and ICU readmission rates. Descriptive and multivariable logistic regression models were used to investigate the relationship between postoperative temperature and mortality. Results Of 425,648 postoperative admissions to the ICU, 165,111 (38.8%) experienced hypothermia within 24 h of their admission. Patients with hypothermia had higher hospital mortality rates of 4.3%, compared with 2.1% in the normothermia group (adjusted odds ratio 1.34; 95% confidence interval 1.28–1.39). Mortality rates increased with lower temperatures with the 32–32.9°C group experiencing the highest mortality rate (adjusted odds ratio 3.03; 95% confidence interval 2.30–4.00). ICU readmission rates and hospital and ICU length of stay were similar between groups. Conclusions In this retrospective cohort study we report that ostoperative hypothermia in the ICU setting is common in Austrailia and New Zealand and was associated with an increased mortality rate. Early recognition and prevention of hypothermia in the intensive care setting may be a modifiable risk factor to reduce mortality for this patient cohort.

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Authors

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Jeremy Weiss

first | Austin Hospital | ORCID 0000-0003-3273-1898

Matthew Durie

middle | The Royal Melbourne Hospital | ORCID 0000-0002-4473-9005

Tamishta Hensman

middle | Austin Hospital | ORCID 0000-0002-5469-8542

Tess Evans

middle | The Royal Melbourne Hospital | ORCID 0000-0001-7764-4363

David Pilcher

last | Australian and New Zealand Intensive Care Society | ORCID 0000-0002-8939-7985

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Citation

BibTeX

@article{Weiss2026Hypothermia,
  title = {Hypothermia in the intensive care unit after surgery: a registry based retrospective cohort study},
  author = {Jeremy Weiss and Matthew Durie and Tamishta Hensman and Tess Evans and David Pilcher},
  journal = {BJA Open},
  year = {2026},
  doi = {10.1016/j.bjao.2026.100556},
  url = {https://doi.org/10.1016/j.bjao.2026.100556}
}

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