Hypothermia in injured patients – does it happen often?

Hypothermia is an independent predictor of increased morbidity and mortality in severely injured patients, mainly due to negative effects on coagulation [1]. Hypothermia can result from trauma itself, reduced tissue perfusion, pre-hospital interventions or lack of such. Efforts to increase body temperature by insulation and active re-warming can by life-saving if the risk of hypothermia in these patients is acknowledged. The aim of this study was to investigate the prevalence and severity of hypothermia in a trauma population.

Retrospective analysis of data collected prospectively from the trauma registry at St. Olavs University Hospital, Norway, from 1^st Jan 2004 to 31^st Dec 2006. Hypothermia was defined as temperature ≤ 36°C [2].

1237 trauma patients were identified during the study period. Among these, 67% (N = 827) had their temperature registered in the emergency department. Overall median temperature was 36.5°C (range 15–39.2), and 218 patients (26%) were hypothermic with a median temperature of 35.6°C. Physician staffed transport (consultant anaesthetist) treated 138 patients (63%). See Table 1.

The prevalence of hypothermia could not be assessed due to no recording of temperature in a significant number of our patients. This suggests a less than adequate level of vigilance. Among patients with recorded temperature, a substantial number was hypothermic. It is necessary to address this issue along the entire chain of survival.