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

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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 (7 days or less) and long-stay patients (more than 7 days) 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 4 days, and 16 patients (24 %) stayed in hospital over 7 days (median 15 days). 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 2.5 days (p < 0.001). Alcohol is the most common concomitant factor and every fourth patient spends more than 7 days 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.

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Acknowledgments

The authors would like to thank biostatistician Pasi Ohtonen and research nurses Sinikka Sälkiö and Tarja Lamberg for their valuable contribution with the extraction of data. The authors would like to thank MD Sami Länkimäki for his comments on data collection.

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Authors and Affiliations

  1. Division of Intensive Care Medicine, and Medical Research Center Oulu, Department of Anaesthesiology, Oulu University Hospital and Research Group of Surgery, Anaesthesiology and Intensive Care, Medical Faculty, University of Oulu, Box 21, OUH, 90029, Oulu, Finland

    Jari Pirnes & Tero Ala-Kokko

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  1. Jari Pirnes
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  2. Tero Ala-Kokko
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Correspondence to Jari Pirnes.

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The authors state that they have no conflicts of interest.

Statement of human and animal rights

The study was approved by the Department of Operative Care of the Oulu University Hospital. Due to the retrospective design, an exemption from consent was obtained from the local ethics committee; the data had already been collected for clinical purposes, and none of the patients were contacted for the purposes of this study.

Informed consent

For this type of study formal consent is not required. The data had already been collected for clinical purposes, and none of the patients were contacted for the purposes of this study.

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Pirnes, J., Ala-Kokko, T. Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland. Intern Emerg Med 12, 1225–1233 (2017). https://doi.org/10.1007/s11739-016-1547-y

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  • DOI: https://doi.org/10.1007/s11739-016-1547-y

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