Hypothermia and associated outcomes in seriously injured trauma patients in a predominantly sub-tropical climate

AimThis study aimed to determine factors linked to hypothermia (<35 °C) in Queensland trauma patients. The relationship of hypothermia with mortality, admission to intensive care and hospital length of stay was also explored.MethodsA retrospective analysis of data from the Queensland Trauma Registry was undertaken, and included all patients admitted to hospital for ≥24 h during 2003 and 2004 with an injury severity score (ISS) > 15. Demographic, injury, environmental, care and clinical status factors were considered.ResultsA total of 2182 patients were included; 124 (5.7%) had hypothermia on admission to the definitive care hospital, while a further 156 (7.1%) developed hypothermia during hospitalisation. Factors associated with hypothermia on admission included winter, direct admission to a definitive care hospital, an ISS ≥ 40, a Glasgow Coma Scale of 3 or ventilated and sedated, and hypotension on admission. Hypothermia on admission to the definitive care hospital was an independent predictor of mortality (odds ratio [OR] = 4.05; 95% confidence interval [CI] 2.26–7.24) and hospital length of stay (incidence rate ratio [IRR] = 1.22; 95% CI 1.03–1.43). Hypothermia during definitive care hospitalisation was independently associated with mortality (OR = 2.52; 95% CI 1.52–4.17), intensive care admission (OR = 1.73; 95% CI 1.20–2.93) and hospital length of stay (IRR = 1.18; 95% CI 1.02–1.36).ConclusionsTrauma patients in a predominantly sub-tropical climate are at risk of accidental and endogenous hypothermia, with associated higher mortality and care requirements. Prevention of hypothermia is important for all severely injured patients.