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Accidental cold-related injury leading to hospitalization in northern Sweden: an eight-year retrospective analysis.

Brändström H, Johansson G, Giesbrecht GG, Ängquist KA, Haney MF - Scand J Trauma Resusc Emerg Med (2014)

Bottom Line: Body core temperature was seldom measured in pre-hospital locations.Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis.Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical and Perioperative Sciences, Anesthesia and Intensive Care Medicine, Faculty of Medicine, Umeå University, S-901 85 Umeå, Sweden. helge.brandstrom@vll.se.

ABSTRACT

Background: Cold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region.

Methods: In this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning. Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32°C), moderate (31.9 - 28°C) and severe (<28°C), hypothermia as well as for frostbite and cold-water drowning.

Results: From the 362 cases, average annual incidences for hypothermia, frostbite, and cold-water drowning were estimated to be 3.4/100,000, 1.5/100,000, and 0.8/100,000 inhabitants, respectively. Annual frequencies for hypothermia hospitalizations increased by approximately 3 cases/year during the study period. Twenty percent of the hypothermia cases were mild, 40% moderate, and 24% severe. For 12%, the lowest documented core temperature was 35°C or higher, for 4% there was no temperature documented. Body core temperature was seldom measured in pre-hospital locations. Of 362 cold injury admissions, 17 (5%) died in hospital related to their injuries. Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis.

Conclusions: The incidence of accidental hypothermia seems to be increasing in this studied sub-arctic region. Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).

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Hypothermia, frostbite and drowning coincided in this cohort only in a minority of cases. Note that for drowning cases, only 18/56 were documented to have become hypothermic. The frostbite cases are those severe enough to be treated in hospital, or where hypothermia was also present.
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Figure 1: Hypothermia, frostbite and drowning coincided in this cohort only in a minority of cases. Note that for drowning cases, only 18/56 were documented to have become hypothermic. The frostbite cases are those severe enough to be treated in hospital, or where hypothermia was also present.

Mentions: There were 362 total cold-related injury patient admissions identified by hospital ICD 10 diagnosis codes during this period (2000-2007). This included 244 hypothermia, 105 frostbite, and 56 outdoor cold-water drowning cases. Twenty-two drownings were in very cold water (< 6°C, winter accident or fallen through ice) ([3]). This corresponded to an estimation of average regional annual incidence of hospitalization during this period for hypothermia of 3.4 per 100 000 residents, along with 1.5 frostbite cases/100 000, and 0.8 drowning cases per 100 000. Co-occurrence of hypothermia, frostbite and drowning was noted for some cases (Figure 1). The main finding was that there was a year-to-year increase in the incidence of hypothermia (p = 0.01) (Figure 2). Frostbite and cold-water drowning incidence did not change over the 8-year period of study. Cold injury events occurred more frequently in men (254, 70%) vs. women (108, 30%; p < 0.003) (Table 1). Time of year and location have an association with cold injury occurrence (Figure 3 and Table 2).


Accidental cold-related injury leading to hospitalization in northern Sweden: an eight-year retrospective analysis.

Brändström H, Johansson G, Giesbrecht GG, Ängquist KA, Haney MF - Scand J Trauma Resusc Emerg Med (2014)

Hypothermia, frostbite and drowning coincided in this cohort only in a minority of cases. Note that for drowning cases, only 18/56 were documented to have become hypothermic. The frostbite cases are those severe enough to be treated in hospital, or where hypothermia was also present.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016575&req=5

Figure 1: Hypothermia, frostbite and drowning coincided in this cohort only in a minority of cases. Note that for drowning cases, only 18/56 were documented to have become hypothermic. The frostbite cases are those severe enough to be treated in hospital, or where hypothermia was also present.
Mentions: There were 362 total cold-related injury patient admissions identified by hospital ICD 10 diagnosis codes during this period (2000-2007). This included 244 hypothermia, 105 frostbite, and 56 outdoor cold-water drowning cases. Twenty-two drownings were in very cold water (< 6°C, winter accident or fallen through ice) ([3]). This corresponded to an estimation of average regional annual incidence of hospitalization during this period for hypothermia of 3.4 per 100 000 residents, along with 1.5 frostbite cases/100 000, and 0.8 drowning cases per 100 000. Co-occurrence of hypothermia, frostbite and drowning was noted for some cases (Figure 1). The main finding was that there was a year-to-year increase in the incidence of hypothermia (p = 0.01) (Figure 2). Frostbite and cold-water drowning incidence did not change over the 8-year period of study. Cold injury events occurred more frequently in men (254, 70%) vs. women (108, 30%; p < 0.003) (Table 1). Time of year and location have an association with cold injury occurrence (Figure 3 and Table 2).

Bottom Line: Body core temperature was seldom measured in pre-hospital locations.Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis.Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical and Perioperative Sciences, Anesthesia and Intensive Care Medicine, Faculty of Medicine, Umeå University, S-901 85 Umeå, Sweden. helge.brandstrom@vll.se.

ABSTRACT

Background: Cold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region.

Methods: In this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning. Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32°C), moderate (31.9 - 28°C) and severe (<28°C), hypothermia as well as for frostbite and cold-water drowning.

Results: From the 362 cases, average annual incidences for hypothermia, frostbite, and cold-water drowning were estimated to be 3.4/100,000, 1.5/100,000, and 0.8/100,000 inhabitants, respectively. Annual frequencies for hypothermia hospitalizations increased by approximately 3 cases/year during the study period. Twenty percent of the hypothermia cases were mild, 40% moderate, and 24% severe. For 12%, the lowest documented core temperature was 35°C or higher, for 4% there was no temperature documented. Body core temperature was seldom measured in pre-hospital locations. Of 362 cold injury admissions, 17 (5%) died in hospital related to their injuries. Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis.

Conclusions: The incidence of accidental hypothermia seems to be increasing in this studied sub-arctic region. Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).

Show MeSH
Related in: MedlinePlus