Analysis of Intraoperative Hypothermia Risk Trajectories in Patients Undergoing Thoracoscopic Surgery: Implications for Predictive Temperature Management

To analyze the intraoperative hypothermia risk trajectory in patients undergoing video-assisted thoracoscopic surgery (VATS) and provide a basis for predictive temperature management, a retrospective study was conducted on 571 VATS patients from a Grade A Tertiary Hospital between January 2022 and December 2023. Intraoperative body temperature change trajectories were plotted, and influencing factors were analyzed via univariate analysis. Results showed three trajectory patterns: "∽"-shaped Normothermia Group (n = 138), "L"-shaped Hypothermia-Nonrecovered Group (n = 297), and "√"-shaped Hypothermia-Recovered Group (n = 136).No statistically significant differences ( P  > 0.05) were observed among the three groups regarding the influence of gender, age, weight, operative time, anesthesia duration, fluid infusion volume, blood loss, or urine output on intraoperative body temperature changes. For the "L"-shaped Hypothermia-Nonrecovered Group, low baseline body temperature serves as an early warning indicator, requiring initiation of active warming 30 minutes before anesthesia induction with combined active and passive warming during the golden 60-minute window to prevent rapid temperature decline; for the "∽"-shaped ; for the "√"-shaped Hypothermia-Recovered Group, maintain warming measures for 60–120 minutes but reduce or discontinue active warming when core temperature ≥ 37.5℃ to prevent hyperthermia. This trajectory-based framework enables predictive temperature management in VATS procedures.