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Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry
  1. Tasuku Matsuyama1,
  2. Sachiko Morita2,
  3. Naoki Ehara3,
  4. Nobuhiro Miyamae4,
  5. Yohei Okada5,
  6. Takaaki Jo6,
  7. Yasuyuki Sumida7,
  8. Nobunaga Okada1,8,
  9. Makoto Watanabe1,
  10. Masahiro Nozawa9,
  11. Ayumu Tsuruoka10,11,
  12. Yoshihiro Fujimoto12,
  13. Yoshiki Okumura13,
  14. Tetsuhisa Kitamura14,
  15. Bon Ohta1
  1. 1 Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
  2. 2 Department of Emergency and Critical Care Medicine, Senri Critical Care Medical Center, Saiseikai Senri Hospital, Suita, Japan
  3. 3 Department of Emergency Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
  4. 4 Department of Emergency Medicine, Rakuwa-kai Otowa Hospital, Kyoto, Japan
  5. 5 Department of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini Red Cross Hospital, Kyoto, Japan
  6. 6 Department of Emergency Medicine, Uji-Tokushukai Medical Center, Uji, Japan
  7. 7 Department of Emergency Medicine, North Medical Center, Kyoto Prefectural University of Medicine, Yosa-gun, Japan
  8. 8 Department of Emergency and Critical Care Medicine, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
  9. 9 Department of Emergency and Critical Care Medicine, Saiseikai Shiga Hospital, Ritto, Japan
  10. 10 Department of Emergency and Critical Care Medicine, Kidney and Cardiovascular Center, Kyoto Min-iren Chuo Hospital, Kyoto, Japan
  11. 11 Department of Emergency and Critical Care Medicine, Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
  12. 12 Department of Emergency Medicine, Yodogawa Christian Hospital, Osaka, Japan
  13. 13 Department of Emergency Medicine, Fukuchiyama City Hospital, Fukuchiyama, Japan
  14. 14 Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita City, Japan
  1. Correspondence to Dr. Tasuku Matsuyama, Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; task-m{at}koto.kpu-m.ac.jp

Abstract

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.

  • environmental medicine
  • epidemiology
  • geriatrics

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Footnotes

  • Contributors TM contributed to the study concept and design, analysis and interpretation of the data, drafting of the manuscript and critical revision of the manuscript. SM, NE, NM, YohO, TJ, YS, NO, MW, MN, AT, YF and YosO collected the data and contributed to the study concept and design and the interpretation of the data, and the critical revision of the manuscript. TK and BO contributed to the study concept and design, and the critical revision of the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Kyoto Prefectural University of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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