Pediatric frostbite: A 10-year single-center retrospective study

Abstract

ObjectiveTo describe frostbite (freezing cold injured tissue) in children and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to the injury. MethodsRetrospective chart review of children <18 years old referred to a regional pediatric hospital for frostbite, to determine the demographics, environment, and risk factors related to injuries. Results47 patients met the inclusion criteria. Median age was 15 years (IQR 12–16). All injuries occurred between November and March. 49% were admitted to the hospital and frostbite was associated with use of alcohol (53%), cigarettes (34%), marijuana (23%), and symptoms of depression (with and without suicidal ideation) (32%). Frostbite injury treated with conservative wound management presented at <−6°C and injury that underwent surgical procedures occurred at temperatures ≤−23°C (p=0.001). Longer exposure duration also significantly increased the likelihood of a surgical procedure (p<0.001). Intoxication and lack of supervision were two common factors, with lack of supervision at time of injury most common among patients 0–12 years (64%), and intoxication most common among patients ages 13–17 (61%). ConclusionFrostbite injuries in children begins at temperatures <−6°C; with risk of tissue loss increasing at temperatures below −23°C. Lack of supervision and intoxication are major risk factors for frostbite in children. Two-thirds of younger children were unsupervised, whereas intoxication was frequently related to frostbite in adolescents. Both of these factors can be addressed through an education-based prevention program.