title: The effect of admission spontaneous hypothermia on patients with severe traumatic brain injury.
abstract: BACKGROUND
  Recent information has emerged regarding the harmful effects of spontaneous hypothermia at time of admission in trauma patients. However the volume of evidence regarding the role of spontaneous hypothermia in TBI patients is inadequate.
  
  
  METHODS
  We performed secondary data analysis of 10 years of the Pennsylvania trauma outcome study (PTOS) database. Unadjusted comparisons of the association of admission spontaneous hypothermia with mortality were performed. In addition, full assessment of the association of hypothermia with mortality was conducted using multivariable logistic regressions reporting the odds ratios (OR) with the 95% confidence intervals (CI) and P-values.
  
  
  RESULTS
  There were 11,033 patients identified from the PTOS with severe TBI. There were 4839 deaths (43.9%). The proportion of deaths in hypothermic patients was higher than the proportion of deaths in normothermic patients (53.9% vs. 37.4% respectively; P value<0.001). In a multivariable logistic regression model adjusted for demographics, injury characteristics, and information at admission to the trauma centre, the odds of death among patients with hypothermia were 1.70 times the odds of death among patients with normothermia (OR 1.70, 95% CI 1.50-1.93), indicating that the probability of death was significantly higher when patients arrived hypothermic at the trauma centre.
  
  
  CONCLUSIONS
  The presence of spontaneous hypothermia at hospital admission is associated with a significant increase in the risk of mortality in patients with severe TBI. The benefit of maintaining normothermia in severe TBI patients, the impact of prolonged re-warming in patients with established hypothermia and the introduction of prophylactic measures to complications of hypothermia are key points that require further investigation.
authors.affiliation: Neiva University Hospital, South Colombian University, Colombia. andresrubiano@aol.com
authors.forename: Andrés M
authors.initials: AM
authors.lastname: Rubiano
authors.forename: Alvaro I
authors.initials: AI
authors.lastname: Sanchez
authors.forename: Glyn
authors.initials: G
authors.lastname: Estebanez
authors.forename: Andrew
authors.initials: A
authors.lastname: Peitzman
authors.forename: Jason
authors.initials: J
authors.lastname: Sperry
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Puyana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000401:mortality / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000401:mortality*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017694:Rewarming / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult