Abstract：
BACKGROUND: Trauma patients with hypothermia have substantial increases in mortality and morbidity. In severely injured patients, hypothermia is common with a rate up to 50% in various geographic areas. This study aims to elucidate the incidence, predictors, and impact of hypothermia on outcomes in severely injured patients.
METHODS: This was a retrospective cohort study which included trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted to a level 1 trauma center in the Netherlands between January 1, 2015 and December 31, 2021. Primary outcome was incidence of hypothermia on arrival at the emergency department. Factors associated with hypothermia were identified. Secondary outcomes were transfusion requirement, mortality, and intensive care unit (ICU) admission. Logistic regression analysis was used to identify associations.
RESULTS: A total of 2032 severely injured patients were included of which 257 (12.6%) were hypothermic on hospital arrival. Predictors for hypothermia on hospital arrival included higher ISS, prehospital intubation, cervical spine immobilization, winter months, systolic blood pressure (SBP) < 90 mmHg and Glasgow Coma Scale (GCS) ≤ 8. Hypothermia was independently associated with transfusion requirement (OR, 2.68; 95% CI, 1.94 - 3.73; p < 0.001), mortality (OR, 2.12; 95% CI, 1.40 - 3.19; p < 0.001) and more often ICU admission (OR, 1.81; 95% CI, 1.10 - 2.97, p = 0.019).
CONCLUSIONS: In this study, hypothermia was present in 12.6% of severely injured patients. Hypothermia was associated with increased transfusion requirement, mortality, and ICU admission. Identified predictors for hypothermia included the severity of injury, intubation, and immobilization, as well as winter season, SBP < 90 mmHg, and GCS ≤ 8.
METHODS: This was a retrospective cohort study which included trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted to a level 1 trauma center in the Netherlands between January 1, 2015 and December 31, 2021. Primary outcome was incidence of hypothermia on arrival at the emergency department. Factors associated with hypothermia were identified. Secondary outcomes were transfusion requirement, mortality, and intensive care unit (ICU) admission. Logistic regression analysis was used to identify associations.
RESULTS: A total of 2032 severely injured patients were included of which 257 (12.6%) were hypothermic on hospital arrival. Predictors for hypothermia on hospital arrival included higher ISS, prehospital intubation, cervical spine immobilization, winter months, systolic blood pressure (SBP) < 90 mmHg and Glasgow Coma Scale (GCS) ≤ 8. Hypothermia was independently associated with transfusion requirement (OR, 2.68; 95% CI, 1.94 - 3.73; p < 0.001), mortality (OR, 2.12; 95% CI, 1.40 - 3.19; p < 0.001) and more often ICU admission (OR, 1.81; 95% CI, 1.10 - 2.97, p = 0.019).
CONCLUSIONS: In this study, hypothermia was present in 12.6% of severely injured patients. Hypothermia was associated with increased transfusion requirement, mortality, and ICU admission. Identified predictors for hypothermia included the severity of injury, intubation, and immobilization, as well as winter season, SBP < 90 mmHg, and GCS ≤ 8.
摘要：
背景：低温创伤患者的死亡率和发病率显著增加。在严重受伤的病人中，在不同的地理区域，低体温的发生率高达50％。这项研究旨在阐明发病率，预测因子,以及低温对严重损伤患者预后的影响。
方法：这是一项回顾性队列研究，包括2015年1月1日至2021年12月31日在荷兰1级创伤中心收治的创伤严重度评分（ISS）≥16的创伤患者。主要结果是到达急诊科时体温过低的发生率。确定了与低体温相关的因素。次要结果是输血需求，死亡率,和重症监护病房(ICU)入院。Logistic回归分析用于确定相关性。
结果：共包括2032例严重受伤患者，其中257例（12.6%）在到达医院时体温过低。到达医院后体温过低的预测因素包括更高的ISS，院前插管,颈椎固定,冬季，收缩压（SBP）<90mmHg，格拉斯哥昏迷评分（GCS）≤8。低体温与输血需求独立相关(OR，2.68；95%CI，1.94-3.73；p<0.001），死亡率(或，2.12；95%CI，1.40-3.19；p<0.001）和更多的ICU入院（OR，1.81；95%CI，1.10-2.97，p=0.019）。
结论：在这项研究中，12.6％的严重受伤患者存在体温过低。体温过低与输血需求增加有关，死亡率,ICU入院。确定的低温预测因子包括损伤的严重程度，插管,和固定，以及冬季，SBP<90mmHg,GCS≤8。
方法：这是一项回顾性队列研究，包括2015年1月1日至2021年12月31日在荷兰1级创伤中心收治的创伤严重度评分（ISS）≥16的创伤患者。主要结果是到达急诊科时体温过低的发生率。确定了与低体温相关的因素。次要结果是输血需求，死亡率,和重症监护病房(ICU)入院。Logistic回归分析用于确定相关性。
结果：共包括2032例严重受伤患者，其中257例（12.6%）在到达医院时体温过低。到达医院后体温过低的预测因素包括更高的ISS，院前插管,颈椎固定,冬季，收缩压（SBP）<90mmHg，格拉斯哥昏迷评分（GCS）≤8。低体温与输血需求独立相关(OR，2.68；95%CI，1.94-3.73；p<0.001），死亡率(或，2.12；95%CI，1.40-3.19；p<0.001）和更多的ICU入院（OR，1.81；95%CI，1.10-2.97，p=0.019）。
结论：在这项研究中，12.6％的严重受伤患者存在体温过低。体温过低与输血需求增加有关，死亡率,ICU入院。确定的低温预测因子包括损伤的严重程度，插管,和固定，以及冬季，SBP<90mmHg,GCS≤8。
