ArticleFrontiers in pediatrics2026
Development and validation of an intraoperative hypothermia risk assessment scale for school-aged children.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intraoperative hypothermia (core temperature <36 °C) is a common and detrimental complication in pediatric surgery. School-aged children (6-12 years) possess unique physiological vulnerabilities, yet a validated, age-specific risk assessment tool is lacking, leading to potential gaps in targeted prevention. Objective: To develop and preliminarily validate a specialized intraoperative hypothermia risk assessment scale for school-aged children undergoing surgery. Methods: This prospective scale development and validation study had three phases. First, a literature review defined the initial item pool. Second, a two-round Delphi consultation with 16 pediatric surgery experts (authority coefficients: 0.875, 0.900) refined items and confirmed content validity. The Delphi method was chosen for early-phase tool development to achieve clinical face and content validity via expert consensus, with equal item weighting as a starting point for future optimization. Finally, from July to December 2024, the scale was used on 398 school-aged surgical patients at a tertiary children's hospital. Intraoperative nasopharyngeal temperature monitoring was the reference for hypothermia (core temperature <36 °C after anesthesia induction). Scale reliability was measured by Cronbach's Results: The final scale consists of 13 items across two domains: patient-related factors (4 items) and iatrogenic/procedural factors (9 items). Each item is scored 1-3, yielding a total score range of 13-39, with higher scores indicating greater risk. In the validation cohort of 398 patients (211 males, 187 females; mean age 8.4 ± 2.1 years), the incidence of intraoperative hypothermia was 47.2% (188/398). Baseline characteristics revealed mean BMI 16.8 ± 3.2 kg/m², 62.3% undergoing general anesthesia, and mean surgical duration 2.1 ± 1.4 h. The scale demonstrated acceptable internal consistency (Cronbach's Conclusion: We developed a novel, reliable, and valid risk assessment scale for intraoperative hypothermia in school-aged children. This tool enables risk stratification using preoperatively available information to facilitate individualized warming strategies and potentially improve perioperative outcomes. Further multi-center validation is warranted to confirm its generalizability.
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