Hypothermia and associated outcomes in seriously injured trauma patients in a predominantly sub-tropical climate

Resuscitation. 2009 Feb;80(2):217-23. doi: 10.1016/j.resuscitation.2008.10.021. Epub 2008 Dec 6.

Abstract

Aim: This study aimed to determine factors linked to hypothermia (<35 degrees C) in Queensland trauma patients. The relationship of hypothermia with mortality, admission to intensive care and hospital length of stay was also explored.

Methods: A retrospective analysis of data from the Queensland Trauma Registry was undertaken, and included all patients admitted to hospital for > or =24h during 2003 and 2004 with an injury severity score (ISS)>15. Demographic, injury, environmental, care and clinical status factors were considered.

Results: A total of 2182 patients were included; 124 (5.7%) had hypothermia on admission to the definitive care hospital, while a further 156 (7.1%) developed hypothermia during hospitalisation. Factors associated with hypothermia on admission included winter, direct admission to a definitive care hospital, an ISS> or =40, a Glasgow Coma Scale of 3 or ventilated and sedated, and hypotension on admission. Hypothermia on admission to the definitive care hospital was an independent predictor of mortality (odds ratio [OR]=4.05; 95% confidence interval [CI] 2.26-7.24) and hospital length of stay (incidence rate ratio [IRR]=1.22; 95% CI 1.03-1.43). Hypothermia during definitive care hospitalisation was independently associated with mortality (OR=2.52; 95% CI 1.52-4.17), intensive care admission (OR=1.73; 95% CI 1.20-2.93) and hospital length of stay (IRR=1.18; 95% CI 1.02-1.36).

Conclusions: Trauma patients in a predominantly sub-tropical climate are at risk of accidental and endogenous hypothermia, with associated higher mortality and care requirements. Prevention of hypothermia is important for all severely injured patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Conscious Sedation
  • Female
  • Glasgow Coma Scale
  • Hospitalization
  • Humans
  • Hypotension / epidemiology
  • Hypothermia / epidemiology*
  • Infant
  • Infant, Newborn
  • Injury Severity Score
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Registries
  • Respiration, Artificial
  • Retrospective Studies
  • Seasons
  • Tropical Climate*
  • Wounds and Injuries / epidemiology*
  • Young Adult