Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland.

Abstract

Accidental hypothermia has a low incidence, but is associated with a high mortality rate. Knowledge about concomitant factors, complications, and length of hospital stay is limited. A retrospective cohort study on patients with accidental hypothermia admitted to Oulu University Hospital in Finland, over a 5-year period. Patients were categorized as short-stay patients (7days or less) and long-stay patients (more than 7days) according to their length of stay in hospital. From a total of 105 patients, 67 patients were included in the analyses. Alcohol abuse was the most common concomitant factor (54%). Median length of hospital stay was 4days, and 16 patients (24%) stayed in hospital over 7days (median 15days). Thirty-day mortality was low (14/105, 13%). Patients with long-term hospitalization had a lower initial temperature (28.4 versus 31.2°C, p=0.011), a lower level of consciousness (GCS score 8.4 versus 12.8, p=0.003), more severe acidosis (pH 7.08 versus 7.28, p=0.005, and lactate 7.2 versus 3.9, p=0.043), and a lower level of platelets (183 versus 242, p=0.041) on admission compared with short-stay patients. Thirty-six patients (54%) had at least one complication, and this prolonged median hospital treatment for 2.5days (p<0.001). Alcohol is the most common concomitant factor and every fourth patient spends more than 7days in hospital. Long-term hospitalization is related to a lower core temperature, lower consciousness, more severe lactic acidosis, lower platelet level and infections, rhabdomyolysis, and renal failure.