Risk factors for hypothermia in EMS-treated burn patients.
OBJECTIVE
Hypothermia has been associated with increased mortality in burn patients. We sought to characterize the body temperature of burn patients transported directly to a burn center by emergency medical services (EMS) personnel and identify the factors independently associated with hypothermia.


METHODS
We utilized prospective data collected by a statewide trauma registry to carry out a nested case-control study of burn patients transported by EMS directly to an accredited burn center between 2000 and 2011. Temperature at hospital admission ≤36.5°C was defined as hypothermia. We utilized registry data abstracted from prehospital care reports and hospital records in building a multivariable regression model to identify the factors associated with hypothermia.


RESULTS
Forty-two percent of the sample was hypothermic. Burns of 20-39% total body surface area (TBSA) (OR 1.44; 1.17-1.79) and ≥40% TBSA (OR 2.39; 1.57-3.64) were associated with hypothermia. Hypothermia was also associated with age > 60 (OR 1.50; 1.30-1.74), polytrauma (OR 1.58; 1.19-2.09), prehospital Glasgow Coma Scale <8 (OR 2.01; 1.46-2.78), and extrication (OR 1.49; 1.30-1.71). Hypothermia was also more common in the winter months (OR 1.54; 1.33-1.79) and less prevalent in patients weighing over 90 kg (OR 0.63; 0.46-0.88).


CONCLUSIONS
A substantial proportion of burn patients demonstrate hypothermia at hospital arrival. Risk factors for hypothermia are readily identifiable by prehospital providers. Maintenance of normothermia should be stressed during prehospital care.
Matthew D
MD
Weaver
Jon C
JC
Rittenberger
P Daniel
PD
Patterson
Serina J
SJ
McEntire
Alain C
AC
Corcos
Jenny A
JA
Ziembicki
David
D
Hostler
D000328:Adult; D001833:Body Temperature Regulation / Q000502:physiology; D002053:Burn Units; D002056:Burns / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016022:Case-Control Studies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007035:Hypothermia / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data; D010414:Pennsylvania; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
Burns; emergency medical services; hypothermia