The study investigated the factors that lead to hypothermia during surgery (intraoperative hypothermia) in elderly patients undergoing joint replacement under general anesthesia. 120 elderly patients were included in the research, of which 21 patients (17.50%) developed hypothermia. The analysis revealed that a greater volume of fluids administered during surgery and a longer duration of anesthesia increased the risk of hypothermia, while a higher temperature in the operating room and a higher level of albumin in the blood reduced the risk. The researchers created a prediction model using a nomogram that achieves high accuracy in predicting the occurrence of hypothermia (AUC value 0.994). The model suggests that early identification of high-risk patients and targeted nursing interventions can have a significant impact on clinical outcomes of operations.