Hypothermia and associated outcomes in seriously injured trauma patients in a predominantly sub-tropical climate.
OBJECTIVE
This study aimed to determine factors linked to hypothermia (<35 degrees C) in Queensland trauma patients. The relationship of hypothermia with mortality, admission to intensive care and hospital length of stay was also explored.


METHODS
A retrospective analysis of data from the Queensland Trauma Registry was undertaken, and included all patients admitted to hospital for > or =24h during 2003 and 2004 with an injury severity score (ISS)>15. Demographic, injury, environmental, care and clinical status factors were considered.


RESULTS
A total of 2182 patients were included; 124 (5.7%) had hypothermia on admission to the definitive care hospital, while a further 156 (7.1%) developed hypothermia during hospitalisation. Factors associated with hypothermia on admission included winter, direct admission to a definitive care hospital, an ISS> or =40, a Glasgow Coma Scale of 3 or ventilated and sedated, and hypotension on admission. Hypothermia on admission to the definitive care hospital was an independent predictor of mortality (odds ratio [OR]=4.05; 95% confidence interval [CI] 2.26-7.24) and hospital length of stay (incidence rate ratio [IRR]=1.22; 95% CI 1.03-1.43). Hypothermia during definitive care hospitalisation was independently associated with mortality (OR=2.52; 95% CI 1.52-4.17), intensive care admission (OR=1.73; 95% CI 1.20-2.93) and hospital length of stay (IRR=1.18; 95% CI 1.02-1.36).


CONCLUSIONS
Trauma patients in a predominantly sub-tropical climate are at risk of accidental and endogenous hypothermia, with associated higher mortality and care requirements. Prevention of hypothermia is important for all severely injured patients.
Aitken
L M
LM
Griffith University, Nathan, QLD 4111, Australia. I.aitken@griffith.edu.au
Hendrikz
J K
JK
Dulhunty
J M
JM
Rudd
M J
MJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012621:Seasons; D014329:Tropical Climate; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult