Measure ID

Percentage of patients receiving general anesthesia that had at least one core temperature documented intraoperatively.

Measure Type
Available for Provider Feedback

General anesthesia causes vasodilation thus redistributing body heat from the core to peripheries.  This redistribution can cause hypothermia.  Core temperatures outside the normal range pose significant risks to patients. Pediatric patients are more likely to develop perioperative hypothermia due to a high surface area to weight ratio and inability to regulate their own temperature.1 Published research has correlated impaired wound healing, adverse cardiac events, altered drug metabolism, and coagulopathies with unplanned perioperative hypothermia. These adverse outcomes resulted in prolonged hospital stays and increased healthcare expenditures. The mortality rate is almost 20% higher only monitoring skin temperature rather than a core temperature for those who experience malignant hyperthermia during surgery.2  Core temperature measurements are less variable than skin temperature measurements and more accurately represent body temperature.3-5

Measure Time Period

Patients requiring general anesthesia (determined by Anesthesia Technique: General value codes > 0)

  • ASA 5 & 6 including Organ Procurement (CPT: 01990)
  • Cases ≤ 30 minutes. *See other measure build details
  • Procedures:
Success Criteria

Cases with at least one core temperature documented between Anesthesia Start and Patient out of Room. If Patient Out of Room not available then, Anesthesia End.

Other Measure Details

Core or Near Core Temperature Monitoring Includes:

  • Pulmonary Artery Temperature
  • Distal Esophageal Temperature
  • Nasopharyngeal Temperature
  • Tympanic Membrane Temperature
  • Bladder Temperature
  • Rectal Temperature
  • Axillary Temperature (arm must be at patient side)
  • Oral Temperature
  • Zero-Flux Thermometer Temperature

Peripheral Temperatures (not compliant):

  • Skin Temperature
  • Temporal Artery Temperature

Temperature Artifact algorithm:

  • Less than 32.0°C (89.6F)
  • Greater than 40.0°C (104.0F)
  • Any minute-to-minute jumps >0.5°C equivalent. 
    • Example: 0.125°C /15s, 0.25°C / 30s, 1°C / 2mins
  • Conversion from F to C:    F=32 +9/5 (°C)

Note: If temperature site is not present in physiologic concept, will refer to intraop notes.

  • 50191    Monitoring- Temperature Probe Placed
  • 50192    Monitoring- Temperature Probe Location/Type
  • 50174    Postoperative Vital Signs

Algorithm for determining Case Length:

*This measure will include only valid MPOG cases as defined by the Is Valid Case phenotype.

Risk Adjustment

Not applicable.

Provider Attribution

Provider(s) present at Induction End. If not available, then

MPOG Concept Used
  • 3031      Temperature- Temporal Artery
  • 3050      Temp 1- Unspecified Site
  • 3051      Temp 2- Unspecified Site
  • 3052      Temp 1- Monitoring Site
  • 3053      Temp 2- Monitoring Site
  • 3054      Temperature- Skin
  • 3055      Temperature- Esophageal
  • 3056      Temperature- Blood
  • 3057      Temperature- Tympanic
  • 3058      Temperature- Bladder
  • 3059      Temperature- Nasopharyngeal
  • 3060      Temperature- Axillary
  • 3061      Temperature- Rectal
  • 3062      Temperature - Myocardial
  • 3533      Temperature Route
  • 50191    Monitoring- Temperature Probe Placed
  • 50192    Monitoring- Temperature Probe Location/Type
  • 50174    Postoperative Vital Signs
MPOG Phenotypes Used
  1. Kim P, Taghon T, Fetzer M, Tobias JD. Perioperative hypothermia in the pediatric population: a quality improvement project. American journal of medical quality : the official journal of the American College of Medical Quality. 2013;28(5):400-406.
  2. Larach MG, Brandom BW, Allen GC, Gronert GA, Lehman EB. Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the North American malignant hyperthermia registry of the malignant hyperthermia association of the United States. Anesthesia and analgesia. 2014;119(6):1359-1366.
  3. Sun Z, Honar H, Sessler DI, et al. Intraoperative core temperature patterns, transfusion requirement, and hospital duration in patients warmed with forced air. Anesthesiology. 2015;122(2):276-285.
  4. Insler SR, Sessler DI. Perioperative thermoregulation and temperature monitoring. Anesthesiology clinics. 2006;24(4):823-837.
  5. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008;109(2):318-338.
Measure Authors

 Measure Author


 Nirav Shah, MD

 University of Michigan

 Kate Buehler, MS, RN

 University of Michigan

 Meridith Wade, MSN, RN

 University of Michigan

 Jay Jeong

 University of Michigan

 Sachin Kheterapl, MD

 University of Michigan

 MPOG Quality Committeee



Measure Reviewer(s)
Next Review: 2025
 Date Reviewed  Reviewer  Institution  Summary  QC Vote


 Jonathan Kaper

 Corewell East - Trenton



 Date  Criteria  Revision
 04/11/2023  Exclusion  Case Duration algorithm updated to remove Case Start/End phenotypes
 11/03/2022  Success Modified to recognize keyword "NP" as nasopharyngeal route for MPOG concepts 50192, 3533 
 04/14/2022  Success Modified to recognize keyword "continuous temporal temperature" as core temp route for MPOG concepts 50192, 3533
 03/25/2021   Exclusion  Modified to use Obstetric Anesthesia Technique phenotype
 03/05/2021  Success  Add zero flux thermometers as a core temperature route