Impact of hypothermia in the rural, pediatric trauma patient

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

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE:: Hypothermia is an independent predictor of mortality in adult trauma studies. However, the impact of hypothermia on the pediatric trauma population has not been described. The purpose of this study is to evaluate hypothermia as a cofactor to mortality, complications, and among survivors, hospital length of stay parameters in the pediatric trauma population. DESIGN:: Retrospective review of a prospectively collected database (National Trauma Registry of the American College of Surgeons) over a 5-yr period (July 2002 to June 2007). SETTING:: A rural, level I trauma center. PATIENTS:: One thousand six hundred twenty-nine pediatric patients admitted with a traumatic injury. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Multivariate regression models were used to evaluate the association of hypothermia with mortality, infectious complications, organ dysfunction, and among survivors, hospital length of stay parameters. Of 1,629 pediatric trauma patients admitted, 182 (11.1%) patients were hypothermic (temperature below 36°C) on admission. Hypothermia had an adjusted odds ratio (AOR) of 2.41 (95% confidence interval [CI], 1.12-5.22, p = .025) for mortality. After controlling for covariates, hypothermia had associations with developing pneumonia (AOR, 0.185, 95% CI, 0.040-0.853; p = .031) and a bleeding diathesis (AOR, 3.14, 95% CI, 1.04-9.44; p = .042). The median days in the hospital, intensive care unit (ICU), and ventilator were longer in the hypothermic cohort; however, after controlling for covariates, hypothermia was not associated with differences in hospital days, ICU days, or ventilator days. CONCLUSIONS:: Hypothermia is a common problem at admission among pediatric trauma patients. Hypothermia is associated with an increase in the odds of death and the development of a bleeding diathesis, while having decreased odds for developing pneumonia. While the length of stay indicators were longer in the hypothermic cohort among survivors, no significant association was noted with hypothermia for hospital, ICU, or ventilator days after controlling for confounders.

Original languageEnglish (US)
Pages (from-to)199-204
Number of pages6
JournalPediatric Critical Care Medicine
Volume11
Issue number2
DOIs
StatePublished - Mar 2010

Fingerprint

Hypothermia
Pediatrics
Wounds and Injuries
Length of Stay
Mechanical Ventilators
Intensive Care Units
Survivors
Mortality
Odds Ratio
Disease Susceptibility
Confidence Intervals
Pneumonia
Hemorrhage
Trauma Centers
Population
Registries
Databases
Temperature

Keywords

  • Complications
  • Hypothermia
  • Length of stay
  • Multivariate analysis
  • Outcomes
  • Pediatric trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Waibel, B. H., Durham, C. A., Newell, M. A., Schlitzkus, L. L., Sagraves, S. G., & Rotondo, M. F. (2010). Impact of hypothermia in the rural, pediatric trauma patient. Pediatric Critical Care Medicine, 11(2), 199-204. https://doi.org/10.1097/PCC.0b013e3181b80500

Impact of hypothermia in the rural, pediatric trauma patient. / Waibel, Brett H.; Durham, Chris A.; Newell, Mark A.; Schlitzkus, Lisa L.; Sagraves, Scott G.; Rotondo, Michael F.

In: Pediatric Critical Care Medicine, Vol. 11, No. 2, 03.2010, p. 199-204.

Research output: Contribution to journalArticle

Waibel, BH, Durham, CA, Newell, MA, Schlitzkus, LL, Sagraves, SG & Rotondo, MF 2010, 'Impact of hypothermia in the rural, pediatric trauma patient', Pediatric Critical Care Medicine, vol. 11, no. 2, pp. 199-204. https://doi.org/10.1097/PCC.0b013e3181b80500
Waibel BH, Durham CA, Newell MA, Schlitzkus LL, Sagraves SG, Rotondo MF. Impact of hypothermia in the rural, pediatric trauma patient. Pediatric Critical Care Medicine. 2010 Mar;11(2):199-204. https://doi.org/10.1097/PCC.0b013e3181b80500
Waibel, Brett H. ; Durham, Chris A. ; Newell, Mark A. ; Schlitzkus, Lisa L. ; Sagraves, Scott G. ; Rotondo, Michael F. / Impact of hypothermia in the rural, pediatric trauma patient. In: Pediatric Critical Care Medicine. 2010 ; Vol. 11, No. 2. pp. 199-204.
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AU - Sagraves, Scott G.

AU - Rotondo, Michael F.

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N2 - OBJECTIVE:: Hypothermia is an independent predictor of mortality in adult trauma studies. However, the impact of hypothermia on the pediatric trauma population has not been described. The purpose of this study is to evaluate hypothermia as a cofactor to mortality, complications, and among survivors, hospital length of stay parameters in the pediatric trauma population. DESIGN:: Retrospective review of a prospectively collected database (National Trauma Registry of the American College of Surgeons) over a 5-yr period (July 2002 to June 2007). SETTING:: A rural, level I trauma center. PATIENTS:: One thousand six hundred twenty-nine pediatric patients admitted with a traumatic injury. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Multivariate regression models were used to evaluate the association of hypothermia with mortality, infectious complications, organ dysfunction, and among survivors, hospital length of stay parameters. Of 1,629 pediatric trauma patients admitted, 182 (11.1%) patients were hypothermic (temperature below 36°C) on admission. Hypothermia had an adjusted odds ratio (AOR) of 2.41 (95% confidence interval [CI], 1.12-5.22, p = .025) for mortality. After controlling for covariates, hypothermia had associations with developing pneumonia (AOR, 0.185, 95% CI, 0.040-0.853; p = .031) and a bleeding diathesis (AOR, 3.14, 95% CI, 1.04-9.44; p = .042). The median days in the hospital, intensive care unit (ICU), and ventilator were longer in the hypothermic cohort; however, after controlling for covariates, hypothermia was not associated with differences in hospital days, ICU days, or ventilator days. CONCLUSIONS:: Hypothermia is a common problem at admission among pediatric trauma patients. Hypothermia is associated with an increase in the odds of death and the development of a bleeding diathesis, while having decreased odds for developing pneumonia. While the length of stay indicators were longer in the hypothermic cohort among survivors, no significant association was noted with hypothermia for hospital, ICU, or ventilator days after controlling for confounders.

AB - OBJECTIVE:: Hypothermia is an independent predictor of mortality in adult trauma studies. However, the impact of hypothermia on the pediatric trauma population has not been described. The purpose of this study is to evaluate hypothermia as a cofactor to mortality, complications, and among survivors, hospital length of stay parameters in the pediatric trauma population. DESIGN:: Retrospective review of a prospectively collected database (National Trauma Registry of the American College of Surgeons) over a 5-yr period (July 2002 to June 2007). SETTING:: A rural, level I trauma center. PATIENTS:: One thousand six hundred twenty-nine pediatric patients admitted with a traumatic injury. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Multivariate regression models were used to evaluate the association of hypothermia with mortality, infectious complications, organ dysfunction, and among survivors, hospital length of stay parameters. Of 1,629 pediatric trauma patients admitted, 182 (11.1%) patients were hypothermic (temperature below 36°C) on admission. Hypothermia had an adjusted odds ratio (AOR) of 2.41 (95% confidence interval [CI], 1.12-5.22, p = .025) for mortality. After controlling for covariates, hypothermia had associations with developing pneumonia (AOR, 0.185, 95% CI, 0.040-0.853; p = .031) and a bleeding diathesis (AOR, 3.14, 95% CI, 1.04-9.44; p = .042). The median days in the hospital, intensive care unit (ICU), and ventilator were longer in the hypothermic cohort; however, after controlling for covariates, hypothermia was not associated with differences in hospital days, ICU days, or ventilator days. CONCLUSIONS:: Hypothermia is a common problem at admission among pediatric trauma patients. Hypothermia is associated with an increase in the odds of death and the development of a bleeding diathesis, while having decreased odds for developing pneumonia. While the length of stay indicators were longer in the hypothermic cohort among survivors, no significant association was noted with hypothermia for hospital, ICU, or ventilator days after controlling for confounders.

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KW - Length of stay

KW - Multivariate analysis

KW - Outcomes

KW - Pediatric trauma

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