Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors
Abstract Background Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. Methods This was an ancil...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-04-01
|
| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13049-017-0349-1 |
| _version_ | 1817978716333015040 |
|---|---|
| author | Frédéric Lapostolle James Couvreur François Xavier Koch Dominique Savary Armelle Alhéritière Michel Galinski Jean-Luc Sebbah Karim Tazarourte Frédéric Adnet |
| author_facet | Frédéric Lapostolle James Couvreur François Xavier Koch Dominique Savary Armelle Alhéritière Michel Galinski Jean-Luc Sebbah Karim Tazarourte Frédéric Adnet |
| author_sort | Frédéric Lapostolle |
| collection | DOAJ |
| description | Abstract Background Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. Methods This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit. The following data were recorded: victim demographics, circumstances of the trauma, environmental factors, patient presentation, clinical data and time from accident to EMS arrival. Independent risk factors for hypothermia were analyzed in a multivariate logistic regression model. Results A total of 461 trauma patients were included in the study. Road traffic accidents (N = 261; 57%) and falls (N = 65; 14%) were the main causes of trauma. Hypothermia (<35 °C) was present in 136/461 cases (29%). Independent factors significantly associated with the presence of hypothermia were: a low GCS (Odds Ratio (OR) = 0,87 ([0,81-0,92]; p < 0.0001), a low air temperature (OR = 0,93 [0,91-0,96]; p < 0.0001) and a wet patient (OR = 2,08 [1,08-4,00]; p = 0.03). Conclusion The incidence of hypothermia was high on EMS arrival at the scene. Body temperature measurement and immediate thermal protection should be routine, and special attention should be given to patients who are wet. Level of evidence Prospective, multicenter, open, observational study; Level IV. |
| first_indexed | 2024-04-13T22:33:47Z |
| format | Article |
| id | doaj.art-bd049a8facdc45b5859691288f577c47 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-04-13T22:33:47Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-bd049a8facdc45b5859691288f577c472022-12-22T02:26:51ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412017-04-012511610.1186/s13049-017-0349-1Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factorsFrédéric Lapostolle0James Couvreur1François Xavier Koch2Dominique Savary3Armelle Alhéritière4Michel Galinski5Jean-Luc Sebbah6Karim Tazarourte7Frédéric Adnet8SAMU 93, Unité de recherche-enseignement-qualitéUniversité Paris 13, Sorbonne Paris CitéPôle Urgence-SAMU-SMUR, Hôpital MichallonSAMU 74SAMU 93, Unité de recherche-enseignement-qualitéSAMU 93, Unité de recherche-enseignement-qualitéSMUR, Centre hospitalier de GonessePôle urgence-réanimation-SAMU 77, Centre hospitalier Marc JacquetSAMU 93, Unité de recherche-enseignement-qualitéAbstract Background Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. Methods This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit. The following data were recorded: victim demographics, circumstances of the trauma, environmental factors, patient presentation, clinical data and time from accident to EMS arrival. Independent risk factors for hypothermia were analyzed in a multivariate logistic regression model. Results A total of 461 trauma patients were included in the study. Road traffic accidents (N = 261; 57%) and falls (N = 65; 14%) were the main causes of trauma. Hypothermia (<35 °C) was present in 136/461 cases (29%). Independent factors significantly associated with the presence of hypothermia were: a low GCS (Odds Ratio (OR) = 0,87 ([0,81-0,92]; p < 0.0001), a low air temperature (OR = 0,93 [0,91-0,96]; p < 0.0001) and a wet patient (OR = 2,08 [1,08-4,00]; p = 0.03). Conclusion The incidence of hypothermia was high on EMS arrival at the scene. Body temperature measurement and immediate thermal protection should be routine, and special attention should be given to patients who are wet. Level of evidence Prospective, multicenter, open, observational study; Level IV.http://link.springer.com/article/10.1186/s13049-017-0349-1TraumaBody temperaturePrehospital settings |
| spellingShingle | Frédéric Lapostolle James Couvreur François Xavier Koch Dominique Savary Armelle Alhéritière Michel Galinski Jean-Luc Sebbah Karim Tazarourte Frédéric Adnet Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Trauma Body temperature Prehospital settings |
| title | Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors |
| title_full | Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors |
| title_fullStr | Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors |
| title_full_unstemmed | Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors |
| title_short | Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors |
| title_sort | hypothermia in trauma victims at first arrival of ambulance personnel an observational study with assessment of risk factors |
| topic | Trauma Body temperature Prehospital settings |
| url | http://link.springer.com/article/10.1186/s13049-017-0349-1 |
| work_keys_str_mv | AT fredericlapostolle hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT jamescouvreur hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT francoisxavierkoch hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT dominiquesavary hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT armellealheritiere hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT michelgalinski hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT jeanlucsebbah hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT karimtazarourte hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors AT fredericadnet hypothermiaintraumavictimsatfirstarrivalofambulancepersonnelanobservationalstudywithassessmentofriskfactors |