Impact of Hypothermia (below 36°C) in the Rural Trauma Patient

Brett H. Waibel, Lisa L Schlitzkus, Mark A. Newell, Christopher A. Durham, Scott G. Sagraves, Michael F. Rotondo

Research output: Contribution to journalArticle

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Abstract

Background: Hypothermia is an independent predictor of mortality based on urban studies. But this association has not been described in the rural setting. This study's purpose was to evaluate hypothermia as a cofactor to mortality, complications, and hospital length of stay (LOS) parameters in the rural trauma setting. Study Design: The National Trauma Registry of the American College of Surgeons database for our rural, Level I trauma center was queried for a 5-year period (July 2002 to June 2007) to identify adult trauma patients. Multivariate regression models were used to evaluate the association of hypothermia with mortality; infectious complications; organ dysfunction; and, among survivors, hospital LOS parameters. Results: Of 9,482 adult patients admitted, 1,490 (15.7%) patients were hypothermic. Hypothermia had an adjusted odds ratio of 1.70 for mortality (95% CI, 1.35 to 2.12; p < 0.001). After controlling for covariates, hypothermia was not significantly associated with infectious complications or organ dysfunction, except for arrhythmia (adjusted odds ratio, 1.40; CI, 1.03 to 1.90; p = 0.031). Hypothermia was not associated with a difference in ICU (p = 0.310) or ventilator (p = 0.144) LOS. But a slight increase in hospital days was noted in the hypothermic patient (hazards ratio, 0.890 for discharge; 95% CI, 0.838 to 0.946; p < 0.001). Conclusions: Hypothermia is a common problem at admission in a rural trauma center. It is associated with an increase in hospitalized days but not with increased ICU or ventilator days among survivors. Other than arrhythmias, it was not significantly associated with other National Trauma Registry of the American College of Surgeons infectious or organ dysfunction complications. Hypothermia is an independent risk factor for mortality in the rural trauma patient.

Original languageEnglish (US)
Pages (from-to)580-588
Number of pages9
JournalJournal of the American College of Surgeons
Volume209
Issue number5
DOIs
StatePublished - Nov 1 2009

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Hypothermia
Wounds and Injuries
Length of Stay
Mortality
Trauma Centers
Mechanical Ventilators
Survivors
Registries
Cardiac Arrhythmias
Odds Ratio
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Waibel, B. H., Schlitzkus, L. L., Newell, M. A., Durham, C. A., Sagraves, S. G., & Rotondo, M. F. (2009). Impact of Hypothermia (below 36°C) in the Rural Trauma Patient. Journal of the American College of Surgeons, 209(5), 580-588. https://doi.org/10.1016/j.jamcollsurg.2009.07.021

Impact of Hypothermia (below 36°C) in the Rural Trauma Patient. / Waibel, Brett H.; Schlitzkus, Lisa L; Newell, Mark A.; Durham, Christopher A.; Sagraves, Scott G.; Rotondo, Michael F.

In: Journal of the American College of Surgeons, Vol. 209, No. 5, 01.11.2009, p. 580-588.

Research output: Contribution to journalArticle

Waibel, BH, Schlitzkus, LL, Newell, MA, Durham, CA, Sagraves, SG & Rotondo, MF 2009, 'Impact of Hypothermia (below 36°C) in the Rural Trauma Patient', Journal of the American College of Surgeons, vol. 209, no. 5, pp. 580-588. https://doi.org/10.1016/j.jamcollsurg.2009.07.021
Waibel BH, Schlitzkus LL, Newell MA, Durham CA, Sagraves SG, Rotondo MF. Impact of Hypothermia (below 36°C) in the Rural Trauma Patient. Journal of the American College of Surgeons. 2009 Nov 1;209(5):580-588. https://doi.org/10.1016/j.jamcollsurg.2009.07.021
Waibel, Brett H. ; Schlitzkus, Lisa L ; Newell, Mark A. ; Durham, Christopher A. ; Sagraves, Scott G. ; Rotondo, Michael F. / Impact of Hypothermia (below 36°C) in the Rural Trauma Patient. In: Journal of the American College of Surgeons. 2009 ; Vol. 209, No. 5. pp. 580-588.
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abstract = "Background: Hypothermia is an independent predictor of mortality based on urban studies. But this association has not been described in the rural setting. This study's purpose was to evaluate hypothermia as a cofactor to mortality, complications, and hospital length of stay (LOS) parameters in the rural trauma setting. Study Design: The National Trauma Registry of the American College of Surgeons database for our rural, Level I trauma center was queried for a 5-year period (July 2002 to June 2007) to identify adult trauma patients. Multivariate regression models were used to evaluate the association of hypothermia with mortality; infectious complications; organ dysfunction; and, among survivors, hospital LOS parameters. Results: Of 9,482 adult patients admitted, 1,490 (15.7{\%}) patients were hypothermic. Hypothermia had an adjusted odds ratio of 1.70 for mortality (95{\%} CI, 1.35 to 2.12; p < 0.001). After controlling for covariates, hypothermia was not significantly associated with infectious complications or organ dysfunction, except for arrhythmia (adjusted odds ratio, 1.40; CI, 1.03 to 1.90; p = 0.031). Hypothermia was not associated with a difference in ICU (p = 0.310) or ventilator (p = 0.144) LOS. But a slight increase in hospital days was noted in the hypothermic patient (hazards ratio, 0.890 for discharge; 95{\%} CI, 0.838 to 0.946; p < 0.001). Conclusions: Hypothermia is a common problem at admission in a rural trauma center. It is associated with an increase in hospitalized days but not with increased ICU or ventilator days among survivors. Other than arrhythmias, it was not significantly associated with other National Trauma Registry of the American College of Surgeons infectious or organ dysfunction complications. Hypothermia is an independent risk factor for mortality in the rural trauma patient.",
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