Accidental cold-related injury leading to hospitalization in northern Sweden : an eight-year retrospective analysis

• Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
• Main Authors: Brändström, Helge, Johansson, Göran, Giesbrecht, Gordon G., Ängquist, Karl-Axel, Haney, Michael F.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Umeå universitet, Anestesiologi och intensivvård 2014
• Subjects: accidental hypothermia; frostbite; body temperature; rewarming; cold-water drowning; Anesthesiology and Intensive Care; Anestesi och intensivvård; Arctic; Northern Sweden; Subarctic
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-89251; https://doi.org/10.1186/1757-7241-22-6

Background: Cold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region. Methods: In this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning.Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32 degrees C), moderate (31.9 - 28 degrees C) and severe (<28 degrees C), hypothermia as well as for frostbite and cold-water drowning. Results: From the 362 cases, average annual incidences for hypothermia, frostbite, and cold-water drowning were estimated to be 3.4/100 000, 1.5/100 000, and 0.8/100 000 inhabitants, respectively. Annual frequencies for hypothermia hospitalizations increased by approximately 3 cases/year during the study period. Twenty percent of the hypothermia cases were mild, 40% moderate, and 24% severe. For 12%, the lowest documented core temperature was 35 degrees C or higher, for 4% there was no temperature documented. Body core temperature was seldom measured in pre-hospital locations. Of 362 cold injury admissions, 17 (5%) died in hospital related to their injuries. Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis. Conclusions: The incidence of accidental hypothermia seems to be increasing in this studied sub-arctic region. Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).