Epidemiology of accidental hypothermia in polytrauma patients: An analysis of 15,230 patients of the TraumaRegister DGU(R).

Background: Accidental hypothermia (AH) endangers the patient after polytrauma. Past studies have emphasized this entity as a major risk factor. The aim of this study was to describe the epidemiology of accidental hypothermia in major trauma considering the preclinical and clinical course. Predictors should be elucidated. Methods: This is a retrospective investigation from the TraumaRegister DGU(R). Patients were documented in the period between 2002 and 2012. The study compared multiple injured patients with or without hypothermic temperatures. Different groups of body core temperature were analyzed. Preclinical and clinical parameters were documented. Results: 15,230 patients could be included. In 5078 patients temperature was below 36.0[degrees]C. Blunt trauma mechanisms surpassed penetrating injuries. The majority of patients sustained car accidents, accidents involving pedestrians and falls from heights >3m. Preclinical rescue procedures were extensively long in patients with low body temperature. Female gender, GCS = 9, shock on site and in ER, preclinical volume therapy, and time until admission to emergency room are significant risk factors to develop accidental hypothermia of 33[degrees]C. Volume management ranged between 1453 +/- 1051ml (33[degrees]C) and 1058 +/- 768ml (36[degrees]C). Treatment in emergency room was extensively long. In further clinical course, severe accidental hypothermia advanced the clinical development of sepsis and multi organ failure. The overall mortality inclined with decreasing body temperatures. Conclusions: Accidental hypothermia regularly occurred in polytrauma patients. Certain predictors exist i.e. female gender, which facilitate a body core temperature of 33[degrees]C. Preclinical and clinical course match with other polytrauma studies. High incidence rates of sepsis, MOF and mortality in hypothermic patients (33[degrees]C) demonstrate the severity of injury. Unfortunately documentation of body core temperature remains challenging as the number of recorded hypothermic patients appears to be too small. We favor a strict focus on body core temperature on arrival in ER. Level of evidence: Level I. Study type: Original article. Prognostic and epidemiological study type. (C) 2016 Lippincott Williams & Wilkins, Inc.

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2buO2t4