Accidental hypothermia as an independent risk factor of poor neurological outcome in older multiply injured patients with severe traumatic brain injury: a matched pair analysis

Winkelmann, Marcel; Soechtig, W.; Macke, Christian; Schroeter, C.; Clausen, Jan; Zeckey, Christian; Krettek, Christian; Mommsen, Philipp

doi:10.1007/s00068-017-0897-0

Cited by 7 publications

(33 citation statements)

References 47 publications

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Section: Discussionmentioning

confidence: 65%

“…In the current review, two studies reported significantly higher transfusion requirements [ 7 , 31 ] and two other studies significantly higher INR values [ 39 , 41 ] in hypothermic patients compared to normothermic patients. In the setting of severely injured trauma patients, higher transfusion requirements and INR values may serve as surrogate markers for coagulopathy.…”

Section: Discussionmentioning

confidence: 88%

“…Definitions of hypothermia used in the studies included are outlined in Table 1 . Temperature measurement methods were specified in six studies and comprised nasopharyngeal [ 39 ], esophageal [ 1 , 7 , 31 , 32 , 41 ], bladder [ 7 , 31 , 32 ], rectal [ 32 , 39 ], tympanic [ 32 , 41 ], axillary [ 32 ], and oral [ 32 ] temperature probes. Eight studies did not describe the exact method of temperature measurement [ 6 , 8 , 35 – 38 , 40 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Included patients were predominantly male (range 71–79%) [ 6 , 31 , 35 , 36 , 39 , 41 , 42 ]. Eight studies compared the age of the normothermic and hypothermic patient groups [ 7 , 8 , 31 , 35 – 37 , 39 , 40 ]. In the studies by Bukur et al and Martin et al, hypothermic patients were significantly older than normothermic patients [ 8 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…In seven studies, death rates were significantly higher in hypothermic trauma patients compared to normothermic patients [ 8 , 31 , 35 , 37 , 39 – 41 ]. Bukur et al, Rubiano et al, Tohme et al, and Winkelmann et al, in their cohorts consisting of patients with TBI specifically, observed a significantly higher mortality rate when accidental hypothermia was present at hospital admission [ 6 , 7 , 36 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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The Impact of Accidental Hypothermia on Mortality in Trauma Patients Overall and Patients with Traumatic Brain Injury Specifically: A Systematic Review and Meta‐Analysis

et al. 2020

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Background Accidental hypothermia is a known predictor for worse outcomes in trauma patients, but has not been comprehensively assessed in a meta-analysis so far. The aim of this systematic review and meta-analysis was to investigate the impact of accidental hypothermia on mortality in trauma patients overall and patients with traumatic brain injury (TBI) specifically. Methods This is a systematic review and meta-analysis using the Ovid Medline/PubMed database. Scientific articles reporting accidental hypothermia and its impact on outcomes in trauma patients were included in qualitative synthesis. Studies that compared the effect of hypothermia vs. normothermia at hospital admission on in-hospital mortality were included in two meta-analyses on (1) trauma patients overall and (2) patients with TBI specifically. Meta-analysis was performed using a Mantel–Haenszel random-effects model. Results Literature search revealed 264 articles. Of these, 14 studies published 1987–2018 were included in the qualitative synthesis. Seven studies qualified for meta-analysis on trauma patients overall and three studies for meta-analysis on patients with TBI specifically. Accidental hypothermia at admission was associated with significantly higher mortality both in trauma patients overall (OR 5.18 [95% CI 2.61–10.28]) and patients with TBI specifically (OR 2.38 [95% CI 1.53–3.69]). Conclusions In the current meta-analysis, accidental hypothermia was strongly associated with higher in-hospital mortality both in trauma patients overall and patients with TBI specifically. These findings underscore the importance of measures to avoid accidental hypothermia in the prehospital care of trauma patients.

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