Journal Publication

Warming blankets cut shivering in hypothermic elderly surgery patients

A two-phase Chinese study links traditional-medicine constitution, low BMI, and low pre-op temperature to intraoperative hypothermia, and finds active warming lowered postoperative shivering rates.

By AppliedXLJuly 14, 2026

Executive Summary

Researchers characterized which elderly patients develop hypothermia during general anesthesia and then tested whether active warming reduces the complications that follow.
Certain traditional Chinese medicine constitutional types, along with lower body mass and lower starting body temperature, tracked with a substantially higher chance of intraoperative hypothermia.
An inflatable warming blanket, applied promptly once hypothermia was identified, shortened rewarming time and markedly lowered the rate of postoperative shivering compared with standard care.
The results point toward a screening approach that combines simple bedside measures with an inexpensive intervention to manage a common complication in older surgical patients.

The finding

Intraoperative hypothermia, a drop in core body temperature during surgery, affected 36.0% of elderly patients undergoing general anesthesia at the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The study set out to identify which patients run the highest risk and whether a rewarming intervention changes outcomes once hypothermia sets in. Patients classified under certain traditional Chinese medicine constitutional types, specifically Qi Yang deficiency or blood deficiency, showed a higher likelihood of developing hypothermia, as did patients with a body mass index under 24 kg/m² and a preoperative core temperature below 37.0°C. Characteristics

The design

The study ran in two phases. The first was a retrospective review of 500 elderly patients treated between March and August 2022, sorted into hypothermia and non-hypothermia groups and analyzed with univariate and multivariate logistic regression to build a predictive risk model, validated by receiver operating characteristic curve analysis. The second phase, run from September to October 2022, was a randomized controlled trial in 80 elderly patients who had already developed intraoperative hypothermia, comparing standard care against active warming with an inflatable warming blanket in the observation group. Characteristics

The risk factors

Beyond patient-level traits, procedural factors independently raised hypothermia risk: major surgery, an operating room temperature below 24°C, anesthesia lasting two hours or longer, and intraoperative fluid administration of 2,000 ml or more, with odds ratios ranging from 3.258 to 12.305 across these factors. Those figures describe associations drawn from the retrospective cohort rather than a causal mechanism, since the first phase carried no intervention and no control for confounding beyond the modeled covariates. Characteristics

The intervention result

In the randomized second phase, patients who received prompt active warming had shorter rewarming times and a postoperative shivering rate of 5.0%, against 22.5% in the control group. That gap, drawn from a 40-patient-per-arm randomized comparison, is the study's most directly actionable result: a low-cost, bedside-deployable intervention tied to a clear reduction in a common recovery complication. Characteristics

This analysis was produced using AI-assisted reporting systems, AppliedXL data, and official public records. These systems undergo editorial review, quality checks, and regular audits by human experts. Errors may still occur, as with any automated system. Always consult the linked primary sources. Read our AI Editorial Policy.