RT Journal Article
SR Electronic
T1 Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP emermed-2017-207238
DO 10.1136/emermed-2017-207238
A1 Tasuku Matsuyama
A1 Sachiko Morita
A1 Naoki Ehara
A1 Nobuhiro Miyamae
A1 Yohei Okada
A1 Takaaki Jo
A1 Yasuyuki Sumida
A1 Nobunaga Okada
A1 Makoto Watanabe
A1 Masahiro Nozawa
A1 Ayumu Tsuruoka
A1 Yoshihiro Fujimoto
A1 Yoshiki Okumura
A1 Tetsuhisa Kitamura
A1 Bon Ohta
YR 2018
UL http://emj.bmj.com/content/early/2018/06/09/emermed-2017-207238.abstract
AB Background Accidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country.Methods We created an AH registry based on retrospective review of patients visiting the ED of 12 institutions with temperature ≤35°C between April 2011 and March 2016. The severity of AH was classified as mild (≤35, ≥32°C), moderate (<32, ≥28°C) or severe (<28°C). The relationship between in-hospital mortality and severity of AH was assessed using a multivariable logistic regression analysis.Results A total of 572 patients were registered in this registry and 537 patients were eligible for our analysis. The median age was 79 (IQR 66–87) years and the proportion of men was 51.2% (273/537). AH was more likely to occur in elderly patients aged ≥65 years (424/537, 80.0%) and in indoor settings (418/537, 77.8%). The condition most frequently associated with AH, irrespective of severity, was acute medical illness. A lower mean outside temperature was associated with a higher prevalence of AH, and particularly severe AH (p for trend <0.001). The overall proportion of cases resulting in in-hospital death was 24.4% (131/537), with no significant difference between severity levels observed in a multivariable logistic regression analysis (severe group (37/118, 31.4%) vs mild group (42/192, 21.9%), adjusted OR (AOR) 1.01, 95% CI 0.61 to 1.68; and moderate group (52/227, 22.9%) vs mild group, AOR 1.11, 95% CI 0.58 to 2.14).Conclusion Active prevention and intervention should occur for this important public health issue.