Risk Factors for Intraoperative Hypothermia in Patients Undergoing Holmium Laser Lithotripsy for Urinary Calculi

Objective: This study aimed to identify factors contributing to intraoperative hypothermia (core body temperature < 36°C) in patients undergoing holmium laser lithotripsy for urinary stones and develop feasible preventive strategies. Methods: A total of 288 patients who underwent the procedure at Xijing Hospital between April and October 2025 were enrolled. They were divided into a hypothermia group (n=177) and a non-hypothermia group (n=111) based on intraoperative hypothermia occurrence. Univariate analysis was first conducted to screen for potential risk factors, with statistically significant variables (P < 0.05) further included in multivariate logistic regression. A P-value < 0.05 was considered significant for all analyses, and the findings were intended to provide evidence-based guidance for nursing staff. Results: Univariate analysis showed 11 factors with statistical significance: patient gender, age, stone types, preoperative baseline body temperature, hemoglobin level, anesthesia duration, surgery duration, intraoperative positional change rate, irrigation fluid volume, intraoperative fluid input volume, and medical staff’s knowledge, attitude, and practice (KAP) toward thermal protection. Multivariate logistic regression identified four independent risk factors: patient age, preoperative baseline body temperature, anesthesia duration, and irrigation fluid volume (all P < 0.05). Conclusion: Patient age, preoperative baseline body temperature, anesthesia duration, and irrigation fluid volume are key contributors to increased intraoperative hypothermia risk during holmium laser lithotripsy. Strengthening intraoperative temperature management for high-risk patients is crucial to prevent hypothermia and improve postoperative recovery quality.