Limits...
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).

Show MeSH

Related in: MedlinePlus

Annual cold injury events are shown during the study period. Linear regression analysis indicates that there was an increase in hypothermia annual frequency during this period, though not for the other diagnosis groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4016575&req=5

Figure 2: Annual cold injury events are shown during the study period. Linear regression analysis indicates that there was an increase in hypothermia annual frequency during this period, though not for the other diagnosis groups.

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)

Annual cold injury events are shown during the study period. Linear regression analysis indicates that there was an increase in hypothermia annual frequency during this period, though not for the other diagnosis groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Annual cold injury events are shown during the study period. Linear regression analysis indicates that there was an increase in hypothermia annual frequency during this period, though not for the other diagnosis groups.
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