Risk Factors for Hypothermia in EMS-treated Burn Patients

Abstract

Objective. Hypothermia has been associated with increased mortality in burn patients. We sought to characterize the body temperature of burn patients transported directly to a burn center by emergency medical services (EMS) personnel and identify the factors independently associated with hypothermia. Methods. We utilized prospective data collected by a statewide trauma registry to carry out a nested case-control study of burn patients transported by EMS directly to an accredited burn center between 2000 and 2011. Temperature at hospital admission ≤36.5°C was defined as hypothermia. We utilized registry data abstracted from prehospital care reports and hospital records in building a multivariable regression model to identify the factors associated with hypothermia. Results. Forty-two percent of the sample was hypothermic. Burns of 20–39% total body surface area (TBSA) (OR 1.44; 1.17–1.79) and ≥40% TBSA (OR 2.39; 1.57–3.64) were associated with hypothermia. Hypothermia was also associated with age > 60 (OR 1.50; 1.30–1.74), polytrauma (OR 1.58; 1.19–2.09), prehospital Glasgow Coma Scale <8 (OR 2.01; 1.46–2.78), and extrication (OR 1.49; 1.30–1.71). Hypothermia was also more common in the winter months (OR 1.54; 1.33–1.79) and less prevalent in patients weighing over 90 kg (OR 0.63; 0.46–0.88). Conclusions. A substantial proportion of burn patients demonstrate hypothermia at hospital arrival. Risk factors for hypothermia are readily identifiable by prehospital providers. Maintenance of normothermia should be stressed during prehospital care.

Key words: :

• Burns
• hypothermia
• emergency medical services