1.Comparison of Postoperative Shivering Incidence and Associated Factors in Female Patients Undergoing Gynecological or General Surgery
Xuanwei HUANG ; Qingling GU ; Fang YE ; Zhanxin DU ; Zhongxing WANG ; Faling XUE
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):913-922
ObjectiveTo compare the incidence of postoperative shivering between female patients undergoing gynecological and general surgery and to examine perioperative factors associated with postoperative shivering. MethodsThis retrospective study included 12 186 patients who underwent gynecological or general surgery between January 1, 2022, and March 15, 2024, of whom 10 884 female patients constituted the primary analysis population. Among the female patients, 1:1 nearest-neighbor propensity score matching was performed using a caliper of 0.02 on the raw propensity score scale, with exact matching on American Society of Anesthesiologists (ASA) physical status. After matching, the incidence of postoperative shivering was compared using the McNemar test. Conditional logistic regression stratified by matched pair was used to assess the associations of surgical categories and perioperative factors with postoperative shivering. ResultsBefore propensity score matching, the incidences of postoperative shivering were 2.98% (28/940) in the general surgery group and 4.94% (491/9 944) in the gynecological surgery group (P=0.007). After matching, 881 matched pairs were obtained, and the absolute standardized mean differences (SMDs) for all covariates were < 0.10. The incidences of postoperative shivering were 3.06% (27/881) in the general surgery group and 4.99% (44/881) in the gynecological surgery group. The McNemar test without continuity correction yielded P=0.044, whereas the exact McNemar test showed a P value of 0.057. Unifactorial conditional logistic regression showed that gynecological surgery was associated with higher odds of postoperative shivering than general surgery [odds ratio (OR)=1.63, 95% confidence interval (CI): 1.01-2.63, P=0.046]. However, the association was not statistically significant in the multifactorial conditional logistic regression [adjusted odds ratio (aOR)=1.62, 95%CI: 0.78-3.37, P=0.197]. Each 30-min increase in the duration of surgery was associated with 32% higher odds of postoperative shivering (aOR=1.32, 95%CI: 1.07-1.62, P=0.009). Each 1 °C increase in the minimum intraoperative body temperature was associated with lower odds of postoperative shivering, although the association did not reach statistical significance (aOR=0.32, 95%CI: 0.10-1.02, P=0.053). ConclusionAfter propensity score matching, the incidence of postoperative shivering was higher among female patients undergoing gynecological surgery than among those undergoing general surgery; however, neither the exact comparison nor the adjusted association reached statistical significance. A longer duration of surgery was associated with higher odds of postoperative shivering, whereas a higher minimum intraoperative body temperature may be associated with lower odds.
2.Comparison of Postoperative Shivering Incidence and Associated Factors in Female Patients Undergoing Gynecological or General Surgery
Xuanwei HUANG ; Qingling GU ; Fang YE ; Zhanxin DU ; Zhongxing WANG ; Faling XUE
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):913-922
ObjectiveTo compare the incidence of postoperative shivering between female patients undergoing gynecological and general surgery and to examine perioperative factors associated with postoperative shivering. MethodsThis retrospective study included 12 186 patients who underwent gynecological or general surgery between January 1, 2022, and March 15, 2024, of whom 10 884 female patients constituted the primary analysis population. Among the female patients, 1:1 nearest-neighbor propensity score matching was performed using a caliper of 0.02 on the raw propensity score scale, with exact matching on American Society of Anesthesiologists (ASA) physical status. After matching, the incidence of postoperative shivering was compared using the McNemar test. Conditional logistic regression stratified by matched pair was used to assess the associations of surgical categories and perioperative factors with postoperative shivering. ResultsBefore propensity score matching, the incidences of postoperative shivering were 2.98% (28/940) in the general surgery group and 4.94% (491/9 944) in the gynecological surgery group (P=0.007). After matching, 881 matched pairs were obtained, and the absolute standardized mean differences (SMDs) for all covariates were < 0.10. The incidences of postoperative shivering were 3.06% (27/881) in the general surgery group and 4.99% (44/881) in the gynecological surgery group. The McNemar test without continuity correction yielded P=0.044, whereas the exact McNemar test showed a P value of 0.057. Unifactorial conditional logistic regression showed that gynecological surgery was associated with higher odds of postoperative shivering than general surgery [odds ratio (OR)=1.63, 95% confidence interval (CI): 1.01-2.63, P=0.046]. However, the association was not statistically significant in the multifactorial conditional logistic regression [adjusted odds ratio (aOR)=1.62, 95%CI: 0.78-3.37, P=0.197]. Each 30-min increase in the duration of surgery was associated with 32% higher odds of postoperative shivering (aOR=1.32, 95%CI: 1.07-1.62, P=0.009). Each 1 °C increase in the minimum intraoperative body temperature was associated with lower odds of postoperative shivering, although the association did not reach statistical significance (aOR=0.32, 95%CI: 0.10-1.02, P=0.053). ConclusionAfter propensity score matching, the incidence of postoperative shivering was higher among female patients undergoing gynecological surgery than among those undergoing general surgery; however, neither the exact comparison nor the adjusted association reached statistical significance. A longer duration of surgery was associated with higher odds of postoperative shivering, whereas a higher minimum intraoperative body temperature may be associated with lower odds.

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