Frostbite in the United States: An Examination of the National Burn Repository and National Trauma Data Bank.

Abstract

Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of frostbite patients, nor the prevalence of these diagnostic and therapeutic modalities. This is the first look at nationwide trends in the treatment of frostbite in the United States. Patients with frostbite injury were identified in the National Trauma Data Bank (NTDB) and National Burn Repository (NBR). Inclusion criteria were diagnosis codes of frostbite injury. The number of frostbite patients treated each year is relatively stable at NBR (N = 497) contributing centers. The NTDB (N = 388) has shown a trend toward increased numbers of frostbite patients. Both databases show an overwhelmingly male demographic (NBR 81.1%, NTDB 75.8%) with a predominance of lower extremity injury (NBR 47.9%, NTDB 66%). Hospital days were similar in both databases (NBR 10.7, NTDB 9.5). Both databases show that frostbite patients frequently require an intensive care unit (ICU) stay, with an average of 8.5 ICU days for NBR patients and 5.9 days for NTDB patients. Frostbite is often a severe disease process that results in relatively long hospital and ICU stays, as well as frequent significant surgeries including amputation. Often, patients afflicted with frostbite require discharge to skilled care before returning home. As more centers encounter patients with frostbite injury, the need for increased awareness of limb/digit saving treatment modalities should be addressed through education from national associations.