{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:34:46Z","timestamp":1774380886347,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraoperative hypothermia (core temperature &amp;lt;36\u2005\u00b0C) is a common and detrimental complication in pediatric surgery. School-aged children (6\u201312 years) possess unique physiological vulnerabilities, yet a validated, age-specific risk assessment tool is lacking, leading to potential gaps in targeted prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and preliminarily validate a specialized intraoperative hypothermia risk assessment scale for school-aged children undergoing surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective scale development and validation study had three phases. First, a literature review defined the initial item pool. Second, a two\u2014round 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\u2014phase 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\u2014aged surgical patients at a tertiary children's hospital. Intraoperative nasopharyngeal temperature monitoring was the reference for hypothermia (core temperature &amp;lt;36\u2005\u00b0C after anesthesia induction). Scale reliability was measured by Cronbach's\n                      <jats:italic>\u03b1<\/jats:italic>\n                      , and predictive validity was evaluated with ROC curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u20133, yielding a total score range of 13\u201339, with higher scores indicating greater risk. In the validation cohort of 398 patients (211 males, 187 females; mean age 8.4\u2009\u00b1\u20092.1 years), the incidence of intraoperative hypothermia was 47.2% (188\/398). Baseline characteristics revealed mean BMI 16.8\u2009\u00b1\u20093.2\u2005kg\/m\u00b2, 62.3% undergoing general anesthesia, and mean surgical duration 2.1\u2009\u00b1\u20091.4\u2005h. The scale demonstrated acceptable internal consistency (Cronbach's\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.731). The ROC analysis revealed an Area Under the Curve (AUC) of 0.743 (95% CI: 0.692\u20130.794,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), indicating fair discriminative ability. The optimal cut-off score was 28, achieving a sensitivity of 0.752 and a specificity of 0.640 for predicting hypothermia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1770475","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:17:09Z","timestamp":1774369029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of an intraoperative hypothermia risk assessment scale for school-aged children"],"prefix":"10.3389","volume":"14","author":[{"given":"Qingqing","family":"Du","sequence":"first","affiliation":[{"name":"Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University","place":["Shanghai, China"]},{"name":"Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Children\u2019s Hospital, School of 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Medicine, Shanghai Jiao Tong University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"B1","volume-title":"Development of an Intraoperative Hypothermia Risk Assessment Scale for Adult Surgical Patients","author":"Yu","year":"2020"},{"key":"B2","first-page":"259","article-title":"Unintended perioperative hypothermia","volume":"11","author":"Hart","year":"2011","journal-title":"Ochsner J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e7389","DOI":"10.1097\/MD.0000000000007389","article-title":"Effect of an electric blanket plus a forced-air warming system for children with postoperative hypothermia: a randomized 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