TY - JOUR
T1 - The impact of hypothermia on trauma care at the 31st combat support hospital
AU - Arthurs, Zachary
AU - Cuadrado, Daniel
AU - Beekley, Alec
AU - Grathwohl, Kurt
AU - Perkins, Jeremy
AU - Rush, Robert
AU - Sebesta, James
PY - 2006/5
Y1 - 2006/5
N2 - Background: The primary objective of this study was to review the incidence of hypothermia, and its effect on surgical management, resource utilization, and survival at the 31st Combat Support Hospital (CSH). Methods: This study was a retrospective analysis of all combat trauma injuries treated at the 31st CSH over a 12-month period. All trauma admissions were included. Descriptive and inferential analysis were performed using SPSS 11.0 software package (SPSS Inc., Chicago, IL). Results: A cohort of 2848 patients was identified; 18% were hypothermic (temperature <36°C). Hypothermia was significantly (P < .05) correlated with admission Glasgow Coma Scale (GCS), tachycardia, hypotension, lower hematocrit, and acidosis. Hypothermic patients had a significantly higher blood product and factor VIIa requirement. Hypothermia was an independent predictor of operative management of injuries, damage control laparotomy, factor VIIa use, and overall mortality (P < .05). Conclusion: Combat trauma patients have a high percentage of penetrating injuries with variable evacuation times. Hypothermia was a pre-hospital physiologic marker, and independent contributor to overall mortality. Prevention of hypothermia could reduce resource utilization and improve survival in the combat setting.
AB - Background: The primary objective of this study was to review the incidence of hypothermia, and its effect on surgical management, resource utilization, and survival at the 31st Combat Support Hospital (CSH). Methods: This study was a retrospective analysis of all combat trauma injuries treated at the 31st CSH over a 12-month period. All trauma admissions were included. Descriptive and inferential analysis were performed using SPSS 11.0 software package (SPSS Inc., Chicago, IL). Results: A cohort of 2848 patients was identified; 18% were hypothermic (temperature <36°C). Hypothermia was significantly (P < .05) correlated with admission Glasgow Coma Scale (GCS), tachycardia, hypotension, lower hematocrit, and acidosis. Hypothermic patients had a significantly higher blood product and factor VIIa requirement. Hypothermia was an independent predictor of operative management of injuries, damage control laparotomy, factor VIIa use, and overall mortality (P < .05). Conclusion: Combat trauma patients have a high percentage of penetrating injuries with variable evacuation times. Hypothermia was a pre-hospital physiologic marker, and independent contributor to overall mortality. Prevention of hypothermia could reduce resource utilization and improve survival in the combat setting.
KW - Battlefield
KW - Hypothermia
KW - Military
KW - Outcomes
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=33646109580&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2006.02.010
DO - 10.1016/j.amjsurg.2006.02.010
M3 - Article
C2 - 16647346
AN - SCOPUS:33646109580
SN - 0002-9610
VL - 191
SP - 610
EP - 614
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 5
ER -