title: Effects of prehospital hypothermia on transfusion requirements and outcomes: a retrospective observatory trial.
abstract: OBJECTIVE
  Prehospital hypothermia is defined as a core temperature <36.0 °C and has been shown to be an independent risk factor for early death in patients with trauma. In a retrospective study, a possible correlation between the body temperature at the time of admission to the emergency room and subsequent in-hospital transfusion requirements and the in-hospital mortality rate was explored.
  
  
  METHODS
  This is a retrospective single-centre study at a primary care hospital in Germany.
  
  
  METHODS
  15,895 patients were included in this study. Patients were classified by admission temperature and transfusion rate. Excluded were ambulant patients and patients with missing data.
  
  
  METHODS
  The primary outcome values were length of stay (LOS) in days, in-hospital mortality, the transferred amount of packed red blood cells (PRBCs), and admission to an intensive care unit. Secondary influencing variables were the patient's age and the Glasgow Coma Scale.
  
  
  RESULTS
  In 22.85% of the patients, hypothermia was documented. Hypothermic patients died earlier in the course of their hospital stay than non-hypothermic patients (p<0.001). The administration of 1-3 PRBC increased the LOS significantly (p<0.001) and transfused patients had an increased risk of death (p<0.001). Prehospital hypothermia could be an independent risk factor for mortality (adjusted OR 8.521; p=0.001) and increases the relative risk for transfusion by factor 2.0 (OR 2.007; p=0.002).
  
  
  CONCLUSIONS
  Low body temperature at hospital admission is associated with a higher risk of transfusion and death. Hence, a greater awareness of prehospital temperature management should be established.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Klauke
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Gräff
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fleischer
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Boehm
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Guttenthaler
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Baumgarten
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Meybohm
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Wittmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D005858:Germany; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology*; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000458:organization & administration*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: ACCIDENT & EMERGENCY MEDICINE; ANAESTHETICS; Hypothermia; Patient blood management; Transfusion