@article{ref1,
title="Epidemiology, management, and outcomes of accidental hypothermia: a multicenter study of regional care",
journal="American surgeon",
year="2020",
author="Rasmussen, Jessica M. and Cogbill, Thomas H. and Borgert, Andrew J. and Frankki, Susan M. and Kallies, Kara J. and Roberts, Jennifer C. and Cullinane, Daniel C. and Renier, Colleen and Woehrle, Theo and Eyer, Steven D. and Zein Eddine, Savo Bou and Beckman, Marshall and Waller, Christine J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Hypothermia is an uncommon, potentially life-threatening condition. We hypothesized (1) advanced rewarming techniques were more frequent with increased  hypothermia severity, (2) active rewarming is increasingly performed with smaller  intravascular catheters and decreased cardiopulmonary bypass, and (3) mortality was  associated with age, hypothermia severity, and type. <br><br>METHODS: Trauma patients with  temperatures <35°C at 4 ACS-verified trauma centers in Wisconsin and Minnesota from  2006 to 2016 were reviewed. Statistical analysis included chi-square and Fisher's  exact tests. A P value <.05 was considered significant. <br><br>RESULTS: 337 patients met  inclusion criteria; primary hypothermia was identified in 127 (38%), secondary in  113 (34%), and mixed primary/secondary in 96 (28%) patients. Hypothermia was mild in  69%, moderate in 26%, and severe in 5% of patients. Intravascular rewarming catheter  was the most frequent advanced modality (2%), used increasingly since 2014. Advanced  techniques were used for primary (12%) vs. secondary (0%) and mixed (5%) (P =.0002); overall use increased with hypothermia severity but varied by institution. Dysrhythmia, acute kidney injury, and frostbite risk worsened with hypothermia  severity (P <.0001, P =.031, and P <.0001, respectively). Mortality was greatest  in patients with mixed hypothermia (39%, P =.0002) and age >65 years (33%, P =.03). Thirty-day mortality rates were similar among severe, moderate, and mild  hypothermia (P =.44). <br><br>CONCLUSION: Advanced rewarming techniques were used more  frequently in severe and primary hypothermia but varied among institutions. Advanced  rewarming was less common in mixed hypothermia; mortality was highest in this  subgroup. Reliance on smaller intravascular catheters for advanced rewarming  increased over time. Given inconsistencies in management, implementation of  guidelines for hypothermia management appears necessary.<p /> <p>Language: en</p>",
language="en",
issn="0003-1348",
doi="10.1177/0003134820984869",
url="http://dx.doi.org/10.1177/0003134820984869"
}