Materiały źródłowe

• #1 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  According to current data, states with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. […] The greatest number of cases of hypothermia occur in an urban setting and are related to environmental exposure attributed to alcoholism, illicit drug use, or mental illness, often exacerbated by concurrent homelessness. […] A second affected group includes people in an outdoor setting for work or pleasure, including hunters, skiers, climbers, boaters/rafters, and swimmers. […] The US Centers for Disease Control and Prevention (CDC) report the following statistics for deaths by excessive natural cold in the period 1999-2011: Total deaths: 16,911. […] Average deaths per year: 1,301. […] Highest yearly total: 1,536 (2010). […] Lowest yearly total: 1,058 (2006).

• #2 Hypothermia | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816651/all/Hypothermia?q=Disseminated+coagulation+intravascular

  Predominant age: young children and elderly […] From 1999 to 2011, the CDC reported 16,911 deaths due to hypothermia. […] Estimates vary widely; typically a secondary issue.

• #3 Hypothermia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545239/

  About 700 to 1500 hypothermia-related fatalities are reported in the United States each year. The condition most frequently affects adults between the ages of 30 and 49, with occurrence 10 times greater in men than women. However, hypothermia’s true incidence is unknown. Even with optimized in-hospital care, the mortality of moderate to severe hypothermia still approaches 50%. […] Hypothermia occurs when the body releases more heat than it absorbs or generates. Vital factors that help retain heat in the body include central and peripheral nervous system regulation and behavioral adaptation.

• #4 Hypothermia | Concise Medical Knowledge

  https://www.lecturio.com/concepts/hypothermia/

  Hypothermia is more common in cold climates, but occurs throughout the world. In-hospital mortality for moderate and severe hypothermia is 40%. Risk factors include homelessness, alcohol intoxication, substance use disorder, advanced age, and psychiatric disease. […] Accidental hypothermia results from exposure to cold temperatures.

• #5 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  According to current data, states with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. […] The greatest number of cases of hypothermia occur in an urban setting and are related to environmental exposure attributed to alcoholism, illicit drug use, or mental illness, often exacerbated by concurrent homelessness. […] A second affected group includes people in an outdoor setting for work or pleasure, including hunters, skiers, climbers, boaters/rafters, and swimmers. […] The US Centers for Disease Control and Prevention (CDC) report the following statistics for deaths by excessive natural cold in the period 1999-2011: Total deaths: 16,911. […] Average deaths per year: 1,301. […] Highest yearly total: 1,536 (2010). […] Lowest yearly total: 1,058 (2006).

• #6 Care for the Cold: Assessment and Treatment of Accidental Hypothermia – Clinical Advisor

  https://www.clinicaladvisor.com/features/care-for-the-cold-assessment-and-treatment-of-accidental-hypothermia/

  Accidental hypothermia is the most common form of hypothermia encountered in the emergency department. Emergency room encounters for hypothermia are increasing as more individuals search for outdoor activities or engage in winter sports. […] Each year in the United States, approximately 700 people die from accidental primary hypothermia, and about 1500 individuals have hypothermia noted on their death certificate. […] States with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. Cold-related deaths are substantially higher in rural counties rather than urban areas. […] When diagnosing hypothermia, clinicians must also consider underlying etiologies of hypothermia in which the patient has a medical illness or other factor that impairs temperature regulation or predisposes them to heat loss.

• #7 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Accurately estimating the incidence of hypothermia is impossible, as hospital encounters only represent the „tip of the iceberg” in that they reflect the more severe cases. […] Even so, the number of emergency department encounters for hypothermia is growing, as ever-growing numbers of people take to the outdoors in search of adventure. […] Hypothermia is also a disease of urban settings. […] Societal problems with alcoholism, mental illness, and homelessness create a steady stream of these cases to inner-city hospitals. […] Although most cases occur in regions of the country with severe winter weather, other areas with milder climates also experience cases on a regular basis. […] This is especially true in milder climates that experience rapid climate changes either due to seasonal changes or day-to-night changes secondary to altitude.

• #8 Hypothermia – Wikipedia

  https://en.wikipedia.org/wiki/Hypothermia

  Between 1995 and 2004 in the United States, an average of 1,560 cold-related emergency department visits occurred per year and in the years 1999 to 2004, an average of 647 people died per year due to hypothermia. Of deaths reported between 1999 and 2002 in the US, 49% of those affected were 65 years or older and two-thirds were male. Most deaths were not work related (63%) and 23% of affected people were at home. Hypothermia was most common during the autumn and winter months of October through March. […] In the United Kingdom, an estimated 300 deaths per year are due to hypothermia, whereas the annual incidence of hypothermia-related deaths in Canada is 8,000.

• #9 Epidemiology of hypothermia: fatalities and hospitalisations in New Zealand – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7717924/

  Hypothermia occurs within domestic and non-residential settings. Most epidemiological data originate from the northern hemisphere, with little data being generally available concerning cases from New Zealand and Australia. […] The National Health Statistics Centre (New Zealand) records hospital discharges and deaths. This study isolated hypothermia cases, to quantify its incidence and identify risk groups. […] Hypothermia hospitalisations were identified (6.9 per 100,000 per year). There were 176 deaths from hypothermia, representing 0.07% of the 259,325 deaths from all causes for the same period (0.537 per 100,000 people per year); of these fatalities, 72.2% were classified as domestic, and 27.8% as non-residential; of the domestic fatalities, 86.6% were 65 + years and 35.5% of these were male. Within the non-residential category, 75.5% were aged 13-65, of which 94.6% were male. The hospitalisation incidence was 12.7 times the fatality incidence, with the majority of hospitalisations being of domestic origin (88.4% of total), and occurring mostly within the lower and upper age extremes. Neonatal domestic hypothermia accounted for 72.6% of all domestic hospitalisations, and the elderly constituted 72.0% of the remaining cases. The proportion of New Zealand fatalities caused by hypothermia was 0.067%; lower than reported in the United Kingdom.

• #10 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Very young and elderly persons are at increased risk and may present to the emergency department with symptoms that are not clinically obvious or specific for hypothermia, such as altered mental status. […] Older patients appear to be more likely to present with chronic or secondary hypothermia. […] Half of the recorded deaths from accidental hypothermia occurred in individuals older than 65 years.

• #11 Care for the Cold: Assessment and Treatment of Accidental Hypothermia – Clinical Advisor

  https://www.clinicaladvisor.com/features/care-for-the-cold-assessment-and-treatment-of-accidental-hypothermia/

  Elderly individuals and infants are more susceptible to hypothermia. Half of recorded deaths from accidental hypothermia occurred in individuals older than 65 years, and the rate of cold-related deaths for persons aged 75 years and over was substantially higher than that of younger individuals; 15.5 deaths per million among persons aged 75 to 84 years and 39.6 deaths per million among persons aged 85 years and older.

• #12 Care for the Cold: Assessment and Treatment of Accidental Hypothermia – Clinical Advisor

  https://www.clinicaladvisor.com/features/care-for-the-cold-assessment-and-treatment-of-accidental-hypothermia/

  Elderly individuals and infants are more susceptible to hypothermia. Half of recorded deaths from accidental hypothermia occurred in individuals older than 65 years, and the rate of cold-related deaths for persons aged 75 years and over was substantially higher than that of younger individuals; 15.5 deaths per million among persons aged 75 to 84 years and 39.6 deaths per million among persons aged 85 years and older.

• #13 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Approximately 67% were among males. […] The CDC reported the following data from 2019 for death rates attributed to excessive cold or hypothermia in people aged 15 years or older: Higher rates in rural areas compared with urban areas. […] Lowest rates among those aged 15-34 years (0.2 case and 0.5 case per 100,000 population in urban and rural areas, respectively). […] Increased rates by age, with highest rates among those aged 85 years or older (4.6 in urban areas, 8.6 in rural areas). […] The overall mortality rate from hypothermia is similar between men and women. […] Because of a higher incidence of exposure among males, men account for 65% of hypothermia-related deaths. […] A 10-year retrospective study of hypothermia-related deaths in New York City and Houston reported that in both cities, males were more likely to die of hypothermia compared with females.

• #14 Hypothermia-related death | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hypothermia-related-death?embed_domain=external.radpair.com%27%5B0%5D%27%5B0%5Dfavicon.icofavicon.icofavicon.icofavicon.icofavicon.ico&lang=gb

  Hypothermia can affect anyone in extreme cold, but in the presence of helplessness promoting factors also occurs in temperate climates, indoors and in summer 1-3. […] These factors include advanced age, homelessness, substance use and medical conditions, such as trauma, decreased mobility, chronic cardiac or respiratory diseases and altered mental state. […] In infants, the relatively large body surface further increases the potential of rapid heat loss 2,4.

• #15 Epidemiology of hypothermia: fatalities and hospitalisations in New Zealand – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7717924/

  Hypothermia occurs within domestic and non-residential settings. Most epidemiological data originate from the northern hemisphere, with little data being generally available concerning cases from New Zealand and Australia. […] The National Health Statistics Centre (New Zealand) records hospital discharges and deaths. This study isolated hypothermia cases, to quantify its incidence and identify risk groups. […] Hypothermia hospitalisations were identified (6.9 per 100,000 per year). There were 176 deaths from hypothermia, representing 0.07% of the 259,325 deaths from all causes for the same period (0.537 per 100,000 people per year); of these fatalities, 72.2% were classified as domestic, and 27.8% as non-residential; of the domestic fatalities, 86.6% were 65 + years and 35.5% of these were male. Within the non-residential category, 75.5% were aged 13-65, of which 94.6% were male. The hospitalisation incidence was 12.7 times the fatality incidence, with the majority of hospitalisations being of domestic origin (88.4% of total), and occurring mostly within the lower and upper age extremes. Neonatal domestic hypothermia accounted for 72.6% of all domestic hospitalisations, and the elderly constituted 72.0% of the remaining cases. The proportion of New Zealand fatalities caused by hypothermia was 0.067%; lower than reported in the United Kingdom.

• #16 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Approximately 67% were among males. […] The CDC reported the following data from 2019 for death rates attributed to excessive cold or hypothermia in people aged 15 years or older: Higher rates in rural areas compared with urban areas. […] Lowest rates among those aged 15-34 years (0.2 case and 0.5 case per 100,000 population in urban and rural areas, respectively). […] Increased rates by age, with highest rates among those aged 85 years or older (4.6 in urban areas, 8.6 in rural areas). […] The overall mortality rate from hypothermia is similar between men and women. […] Because of a higher incidence of exposure among males, men account for 65% of hypothermia-related deaths. […] A 10-year retrospective study of hypothermia-related deaths in New York City and Houston reported that in both cities, males were more likely to die of hypothermia compared with females.

• #17 Data & Statistical Reports | Hypothermia | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/hypothermia/surveillance.php

  Substance abuse was a factor in 107 of the 208 (51.4%) deaths in this age group. […] The largest number of Missouri hypothermia deaths was among males, comprising 299 (72.2%) of the 414 total cold related deaths. […] Jackson County, St. Louis County and St. Louis City accounted for 44.2% (183) of deaths with 55.8% (231) occurring in other areas of Missouri. […] Since 2006, Missouri has also been using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software to collect emergency department (ED) data. […] Missouri is the only state that conducts on-going statewide surveillance for cold weather-related illnesses and deaths.

• #18 Hypothermia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545239/

  About 700 to 1500 hypothermia-related fatalities are reported in the United States each year. The condition most frequently affects adults between the ages of 30 and 49, with occurrence 10 times greater in men than women. However, hypothermia’s true incidence is unknown. Even with optimized in-hospital care, the mortality of moderate to severe hypothermia still approaches 50%. […] Hypothermia occurs when the body releases more heat than it absorbs or generates. Vital factors that help retain heat in the body include central and peripheral nervous system regulation and behavioral adaptation.

• #19 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Approximately 67% were among males. […] The CDC reported the following data from 2019 for death rates attributed to excessive cold or hypothermia in people aged 15 years or older: Higher rates in rural areas compared with urban areas. […] Lowest rates among those aged 15-34 years (0.2 case and 0.5 case per 100,000 population in urban and rural areas, respectively). […] Increased rates by age, with highest rates among those aged 85 years or older (4.6 in urban areas, 8.6 in rural areas). […] The overall mortality rate from hypothermia is similar between men and women. […] Because of a higher incidence of exposure among males, men account for 65% of hypothermia-related deaths. […] A 10-year retrospective study of hypothermia-related deaths in New York City and Houston reported that in both cities, males were more likely to die of hypothermia compared with females.

• #20 Data & Statistical Reports | Hypothermia | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/hypothermia/surveillance.php

  Substance abuse was a factor in 107 of the 208 (51.4%) deaths in this age group. […] The largest number of Missouri hypothermia deaths was among males, comprising 299 (72.2%) of the 414 total cold related deaths. […] Jackson County, St. Louis County and St. Louis City accounted for 44.2% (183) of deaths with 55.8% (231) occurring in other areas of Missouri. […] Since 2006, Missouri has also been using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software to collect emergency department (ED) data. […] Missouri is the only state that conducts on-going statewide surveillance for cold weather-related illnesses and deaths.

• #21 QuickStats: Death Rates Attributed to Excessive Cold or Hypothermia, by Urbanization Level and Sex — National Vital Statistics System, 2018–2020 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/wr/mm7107a6.htm

  During 20182020, death rates attributed to excessive cold or hypothermia were generally higher in more rural areas. Among females, the death rate increased from 0.11 per 100,000 for those residing in large central metro areas, to 0.40 for those in noncore (rural) areas. Among males, the death rates were lowest for those residing in large central metro areas (0.29) and large fringe metro areas (0.24), and highest in noncore (rural) areas (0.93). Males had higher death rates than females for each corresponding urbanization level. […] Deaths attributed to excessive cold or hypothermia were identified using the International Classification of Diseases, Tenth Revision underlying cause-of-death code X31 (exposure to excessive natural cold) and multiple cause-of-death code T68 (hypothermia).

• #22 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  According to current data, states with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. […] The greatest number of cases of hypothermia occur in an urban setting and are related to environmental exposure attributed to alcoholism, illicit drug use, or mental illness, often exacerbated by concurrent homelessness. […] A second affected group includes people in an outdoor setting for work or pleasure, including hunters, skiers, climbers, boaters/rafters, and swimmers. […] The US Centers for Disease Control and Prevention (CDC) report the following statistics for deaths by excessive natural cold in the period 1999-2011: Total deaths: 16,911. […] Average deaths per year: 1,301. […] Highest yearly total: 1,536 (2010). […] Lowest yearly total: 1,058 (2006).

• #23 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  According to current data, states with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. […] The greatest number of cases of hypothermia occur in an urban setting and are related to environmental exposure attributed to alcoholism, illicit drug use, or mental illness, often exacerbated by concurrent homelessness. […] A second affected group includes people in an outdoor setting for work or pleasure, including hunters, skiers, climbers, boaters/rafters, and swimmers. […] The US Centers for Disease Control and Prevention (CDC) report the following statistics for deaths by excessive natural cold in the period 1999-2011: Total deaths: 16,911. […] Average deaths per year: 1,301. […] Highest yearly total: 1,536 (2010). […] Lowest yearly total: 1,058 (2006).

• #24 Hypothermia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545239/

  About 700 to 1500 hypothermia-related fatalities are reported in the United States each year. The condition most frequently affects adults between the ages of 30 and 49, with occurrence 10 times greater in men than women. However, hypothermia’s true incidence is unknown. Even with optimized in-hospital care, the mortality of moderate to severe hypothermia still approaches 50%. […] Hypothermia occurs when the body releases more heat than it absorbs or generates. Vital factors that help retain heat in the body include central and peripheral nervous system regulation and behavioral adaptation.

• #25 What’s New

  https://www.cdph.ca.gov/Programs/EPO/Pages/Frostbite-and-Hypothermia-.aspx

  People most susceptible to hypothermia are: elderly people with inadequate food, clothing, or heating; individuals with poor circulation; babies sleeping in cold bedrooms without proper clothing for the conditions; children left unattended; adults under the influence of alcohol; mentally ill individuals; people who remain outdoors for long periods—the homeless, hikers, hunters, etc.

• #26 Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a2.htm

  Hypothermia is defined as a core body temperature of 95F (35C) and is caused by environmental exposure, drug intoxication, or metabolic or nervous system dysfunction. Exposure to cold is a leading cause of weather-related mortality and is responsible for approximately twice the number of deaths annually as exposure to heat in the United States. To understand the risk factors for hypothermia-related death and improve prevention efforts, during January 1-April 30, 2014, a period of record low temperatures, the Wisconsin Division of Public Health began active surveillance for hypothermia. […] Hypothermia continues to be an important cause of weather-related death. Key risk factors include drug intoxication, mental illness, and social isolation. State and local health agencies might need to focus outreach on vulnerable populations and target interventions for groups at highest risk for death.

• #27 Data & Statistical Reports | Hypothermia | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/hypothermia/surveillance.php

  Substance abuse was a factor in 107 of the 208 (51.4%) deaths in this age group. […] The largest number of Missouri hypothermia deaths was among males, comprising 299 (72.2%) of the 414 total cold related deaths. […] Jackson County, St. Louis County and St. Louis City accounted for 44.2% (183) of deaths with 55.8% (231) occurring in other areas of Missouri. […] Since 2006, Missouri has also been using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software to collect emergency department (ED) data. […] Missouri is the only state that conducts on-going statewide surveillance for cold weather-related illnesses and deaths.

• #28 Hypothermia-related death | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hypothermia-related-death?embed_domain=external.radpair.com%27%5B0%5D%27%5B0%5Dfavicon.icofavicon.icofavicon.icofavicon.icofavicon.ico&lang=gb

  Hypothermia can affect anyone in extreme cold, but in the presence of helplessness promoting factors also occurs in temperate climates, indoors and in summer 1-3. […] These factors include advanced age, homelessness, substance use and medical conditions, such as trauma, decreased mobility, chronic cardiac or respiratory diseases and altered mental state. […] In infants, the relatively large body surface further increases the potential of rapid heat loss 2,4.

• #29 Hypothermia-related death | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hypothermia-related-death?embed_domain=external.radpair.com%27%5B0%5D%27%5B0%5Dfavicon.icofavicon.icofavicon.icofavicon.icofavicon.ico&lang=gb

  Hypothermia can affect anyone in extreme cold, but in the presence of helplessness promoting factors also occurs in temperate climates, indoors and in summer 1-3. […] These factors include advanced age, homelessness, substance use and medical conditions, such as trauma, decreased mobility, chronic cardiac or respiratory diseases and altered mental state. […] In infants, the relatively large body surface further increases the potential of rapid heat loss 2,4.

• #30 Severe Hypothermia – RCEMLearning

  https://www.rcemlearning.co.uk/reference/severe-hypothermia/

  The incidence of hypothermia in Great Britain is estimated at 6-8 patients per 1000 patients. […] Accurately estimating the incidence of hypothermia is extremely difficult as hospital attendances only represent the tip of the iceberg in that they reflect the more severe cases. […] In 2020 there were 40 deaths in Scotland that involved hypothermia. Of these 40 deaths, hypothermia was the underlying cause in 4 deaths and a contributing factor in 36. […] Primary hypothermia usually affects young males and infants. Secondary hypothermia usually affects patients who are elderly, homeless, mentally ill, victims of trauma, or have multiple co-morbidities.

• #31 Hypothermia – Core EM

  https://coreem.net/core/hypothermia/

  During 20062010 exposure to excessive natural cold, hypothermia, or both was cited for 6,660 deaths (Berko 2006, PMID: 25073563) […] Subpopulations at risk for cold-related morbidity (Berko 2006, PMID: 25073563) […] Most patients in urban EDs are not skiing or falling through ice […] Unlike an exposed mountaineer, hypothermia in urban ED is more likely secondary in nature and related to impaired thermoregulation, inability to seek shelter […] Retrospective studies show that death is often due to severity of underlying disease, especially infection, rather than a numerical temperature […] In urban settings hypothermia is often a reflection of underlying disease state, the rate of rewarming can reflect underlying pathology (i.e. inability of a sick patient to warm themselves); sepsis is an under-appreciated cause.

• #32 Epidemiology, Management, and Outcomes of Accidental Hypothermia: A Multicenter Study of Regional Care. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=00031348&AN=157106998&h=5EOSjyAjNzT09%2BIUJkulBHDyWDfXv%2FczOJuW8LP2NI%2FZrwver5xK7eGMbOuNVYXMPESPj0eENWr8lr5QQbpH0w%3D%3D&crl=f

  Hypothermia is an uncommon, potentially life-threatening condition. […] 337 patients met inclusion criteria; primary hypothermia was identified in 127 (38%), secondary in 113 (34%), and mixed primary/secondary in 96 (28%) patients. […] Advanced rewarming techniques were used more frequently in severe and primary hypothermia but varied among institutions. […] Given inconsistencies in management, implementation of guidelines for hypothermia management appears necessary.

• #33 Epidemiology, Management, and Outcomes of Accidental Hypothermia: A Multicenter Study of Regional Care. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=00031348&AN=157106998&h=5EOSjyAjNzT09%2BIUJkulBHDyWDfXv%2FczOJuW8LP2NI%2FZrwver5xK7eGMbOuNVYXMPESPj0eENWr8lr5QQbpH0w%3D%3D&crl=f

  Hypothermia is an uncommon, potentially life-threatening condition. […] 337 patients met inclusion criteria; primary hypothermia was identified in 127 (38%), secondary in 113 (34%), and mixed primary/secondary in 96 (28%) patients. […] Advanced rewarming techniques were used more frequently in severe and primary hypothermia but varied among institutions. […] Given inconsistencies in management, implementation of guidelines for hypothermia management appears necessary.

• #34 Update: Cold Injuries, Active and Reserve Components, U.S. Armed Forces, July 2017–June 2022 | Health.mil

  https://health.mil/News/Articles/2022/11/01/Cold-Injuries-MSMR

  From July 2021 through June 2022, a total of 482 members of the active (n=435) and reserve (n=47) components had at least 1 cold injury. […] The term cold injuries is used to describe injuries that have a central effect, such as hypothermia, as well as injuries that primarily affect the peripheries of the body, such as frostbite and immersion injuries. […] Hypothermia occurs when the core temperature of the body falls below 95F. […] Military training and combat operations will require continued emphasis on effective cold injury prevention strategies and adherence to the policies and procedures in place to protect service members against such injuries. […] For the military, continuous surveillance of cold injuries is essential to inform steps to reduce their impact as well as to remind leaders of this predictable threat.

• #35 Update: Cold Injuries, Active and Reserve Components, U.S. Armed Forces, July 2017–June 2022 | Health.mil

  https://health.mil/News/Articles/2022/11/01/Cold-Injuries-MSMR

  From July 2021 through June 2022, a total of 482 members of the active (n=435) and reserve (n=47) components had at least 1 cold injury. […] The term cold injuries is used to describe injuries that have a central effect, such as hypothermia, as well as injuries that primarily affect the peripheries of the body, such as frostbite and immersion injuries. […] Hypothermia occurs when the core temperature of the body falls below 95F. […] Military training and combat operations will require continued emphasis on effective cold injury prevention strategies and adherence to the policies and procedures in place to protect service members against such injuries. […] For the military, continuous surveillance of cold injuries is essential to inform steps to reduce their impact as well as to remind leaders of this predictable threat.

• #36 Update: Cold Injuries, Active and Reserve Components, U.S. Armed Forces, July 2017–June 2022 | Health.mil

  https://health.mil/News/Articles/2022/11/01/Cold-Injuries-MSMR

  From July 2021 through June 2022, a total of 482 members of the active (n=435) and reserve (n=47) components had at least 1 cold injury. […] The term cold injuries is used to describe injuries that have a central effect, such as hypothermia, as well as injuries that primarily affect the peripheries of the body, such as frostbite and immersion injuries. […] Hypothermia occurs when the core temperature of the body falls below 95F. […] Military training and combat operations will require continued emphasis on effective cold injury prevention strategies and adherence to the policies and procedures in place to protect service members against such injuries. […] For the military, continuous surveillance of cold injuries is essential to inform steps to reduce their impact as well as to remind leaders of this predictable threat.

• #37 Update: Cold Injuries, Active and Reserve Components, U.S. Armed Forces, July 2017–June 2022 | Health.mil

  https://health.mil/News/Articles/2022/11/01/Cold-Injuries-MSMR

  The surveillance period was 1 July 2017 through 30 June 2022. […] Because cold injuries represent a threat to the health of individual service members and to military training and operations, the U.S. Armed Forces require expeditious reporting of these reportable medical events (RMEs) via one of the service-specific electronic reporting systems; these reports are routinely incorporated into the Defense Medical Surveillance System (DMSS). […] The numbers of cold injuries were summarized by the locations at which service members were treated for these injuries as identified by the Defense Medical Information System Identifier (DMIS ID) recorded in the medical records of the cold injuries. […] The overall rate of cold injuries in 20212022 decreased slightly compared to the previous cold year.

• #38 Update: Cold Injuries, Active and Reserve Components, U.S. Armed Forces, July 2017–June 2022 | Health.mil

  https://health.mil/News/Articles/2022/11/01/Cold-Injuries-MSMR

  The surveillance period was 1 July 2017 through 30 June 2022. […] Because cold injuries represent a threat to the health of individual service members and to military training and operations, the U.S. Armed Forces require expeditious reporting of these reportable medical events (RMEs) via one of the service-specific electronic reporting systems; these reports are routinely incorporated into the Defense Medical Surveillance System (DMSS). […] The numbers of cold injuries were summarized by the locations at which service members were treated for these injuries as identified by the Defense Medical Information System Identifier (DMIS ID) recorded in the medical records of the cold injuries. […] The overall rate of cold injuries in 20212022 decreased slightly compared to the previous cold year.

• #39 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Accurately estimating the incidence of hypothermia is impossible, as hospital encounters only represent the „tip of the iceberg” in that they reflect the more severe cases. […] Even so, the number of emergency department encounters for hypothermia is growing, as ever-growing numbers of people take to the outdoors in search of adventure. […] Hypothermia is also a disease of urban settings. […] Societal problems with alcoholism, mental illness, and homelessness create a steady stream of these cases to inner-city hospitals. […] Although most cases occur in regions of the country with severe winter weather, other areas with milder climates also experience cases on a regular basis. […] This is especially true in milder climates that experience rapid climate changes either due to seasonal changes or day-to-night changes secondary to altitude.

• #40 Data & Statistical Reports | Hypothermia | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/hypothermia/surveillance.php

  Substance abuse was a factor in 107 of the 208 (51.4%) deaths in this age group. […] The largest number of Missouri hypothermia deaths was among males, comprising 299 (72.2%) of the 414 total cold related deaths. […] Jackson County, St. Louis County and St. Louis City accounted for 44.2% (183) of deaths with 55.8% (231) occurring in other areas of Missouri. […] Since 2006, Missouri has also been using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software to collect emergency department (ED) data. […] Missouri is the only state that conducts on-going statewide surveillance for cold weather-related illnesses and deaths.

• #41 Data & Statistical Reports | Hypothermia | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/hypothermia/surveillance.php

  Substance abuse was a factor in 107 of the 208 (51.4%) deaths in this age group. […] The largest number of Missouri hypothermia deaths was among males, comprising 299 (72.2%) of the 414 total cold related deaths. […] Jackson County, St. Louis County and St. Louis City accounted for 44.2% (183) of deaths with 55.8% (231) occurring in other areas of Missouri. […] Since 2006, Missouri has also been using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software to collect emergency department (ED) data. […] Missouri is the only state that conducts on-going statewide surveillance for cold weather-related illnesses and deaths.

• #42 Cold-Related Illness – CSTE | Knowledge Repository

  https://knowledgerepository.syndromicsurveillance.org/cold-related-illness-cste

  In winter, people are at risk for cold-related illness (CRI) such as hypothermia. […] Deaths coded as weather-related from 2006 through 2010 showed exposure to excessive cold as the leading cause of weather-related deaths in the United States. […] The workgroup collaborated with data analysts and epidemiologists from the NSSPCoP Syndrome Definition Committee and based its approach on that used to develop CSTEs 2016 „Heat-Related Illness Syndrome Query: A Guidance Document for Implementing Heat-Related Illness Syndromic Surveillance in Public Health Practice.” […] To validate the proposed CRI definition, three workgroup members applied it to their public health department data. Further, the New York City Department of Health and Mental Hygiene compared syndrome records with hospital discharge data. […] This collaboration across organizations and public health departments developed the CRI syndrome definition and guidance document Cold-related Illness Query: Guidance for Implementing Cold-related Illness Syndromic Surveillance in Public Health Practice.

• #43 HKU Scholars Hub: The impact of territory-wide surveillance on postoperative hypothermia among elective surgical patients in a major public hospital in Hong Kong

  https://hub.hku.hk/handle/10722/237215

  The impact of territory-wide surveillance on postoperative hypothermia among elective surgical patients in a major public hospital in Hong Kong. […] A Temperature Monitoring Project has been implemented on all anaesthesia departments in Hospital Authority (HA) hospitals to quantify the occurrence of unintentional perioperative hypothermia. […] Given that the surveillance system is a territory-wide intervention across all public hospitals in Hong Kong, using a similar tertiary-wide surveillance system on other clinically important outcomes may further enhance the quality and safety of our health care delivery and hence improving the health outcomes of our population. […] The aim of this study was to determine whether implementing a territory-wide surveillance on post-operative hypothermia by the COC has an impact on outcome among patients who received elective non-cardiac surgical procedures in Tuen Mun Hospital.

• #44 HKU Scholars Hub: The impact of territory-wide surveillance on postoperative hypothermia among elective surgical patients in a major public hospital in Hong Kong

  https://hub.hku.hk/handle/10722/237215

  Implementation of the territory-wide surveillance of post-operative hypothermia has reduced the incidence of hypothermia in elective non-cardiac operations from 18.5% to 12.7% which is also statistically significant. […] The results from this study shows an association between the implementation of territory-wide surveillance program for post-operative hypothermia and reduction of its occurrence in our patients, hence potentially improve the health care quality and safety.

• #45 External validation of 5A score model for predicting in-hospital mortality among the accidental hypothermia patients: JAAM-Hypothermia study 2018–2019 secondary analysis | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-022-00616-5

  The 5A score including five components Age, Activities of daily living, Arrest, Acidemia and Albumin was developed as an easy-to-use screening tool for predicting in-hospital mortality among patients with accidental hypothermia. […] The 5A score model using estimated albumin value has external validity in a completely different dataset from that used for the 5A model development. […] This study aimed to externally validate the 5A score model for predicting in-hospital mortality by using a dataset that is independent from the one used for the development of the 5A score. […] This multicenter observational study conducted the external validation of the 5A score for predicting the in-hospital mortality for the patients with accidental hypothermia. […] The 5A score is potentially helpful to predict the mortality risk and may be one of the valuable information for discussing the treatment strategy with patients and their family members.

• #46 External validation of 5A score model for predicting in-hospital mortality among the accidental hypothermia patients: JAAM-Hypothermia study 2018–2019 secondary analysis | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-022-00616-5

  The 5A score including five components Age, Activities of daily living, Arrest, Acidemia and Albumin was developed as an easy-to-use screening tool for predicting in-hospital mortality among patients with accidental hypothermia. […] The 5A score model using estimated albumin value has external validity in a completely different dataset from that used for the 5A model development. […] This study aimed to externally validate the 5A score model for predicting in-hospital mortality by using a dataset that is independent from the one used for the development of the 5A score. […] This multicenter observational study conducted the external validation of the 5A score for predicting the in-hospital mortality for the patients with accidental hypothermia. […] The 5A score is potentially helpful to predict the mortality risk and may be one of the valuable information for discussing the treatment strategy with patients and their family members.

• #47 External validation of 5A score model for predicting in-hospital mortality among the accidental hypothermia patients: JAAM-Hypothermia study 2018–2019 secondary analysis | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-022-00616-5

  The 5A score including five components Age, Activities of daily living, Arrest, Acidemia and Albumin was developed as an easy-to-use screening tool for predicting in-hospital mortality among patients with accidental hypothermia. […] The 5A score model using estimated albumin value has external validity in a completely different dataset from that used for the 5A model development. […] This study aimed to externally validate the 5A score model for predicting in-hospital mortality by using a dataset that is independent from the one used for the development of the 5A score. […] This multicenter observational study conducted the external validation of the 5A score for predicting the in-hospital mortality for the patients with accidental hypothermia. […] The 5A score is potentially helpful to predict the mortality risk and may be one of the valuable information for discussing the treatment strategy with patients and their family members.

• #48 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  Accurately estimating the incidence of hypothermia is impossible, as hospital encounters only represent the „tip of the iceberg” in that they reflect the more severe cases. […] Even so, the number of emergency department encounters for hypothermia is growing, as ever-growing numbers of people take to the outdoors in search of adventure. […] Hypothermia is also a disease of urban settings. […] Societal problems with alcoholism, mental illness, and homelessness create a steady stream of these cases to inner-city hospitals. […] Although most cases occur in regions of the country with severe winter weather, other areas with milder climates also experience cases on a regular basis. […] This is especially true in milder climates that experience rapid climate changes either due to seasonal changes or day-to-night changes secondary to altitude.

• #49 Care for the Cold: Assessment and Treatment of Accidental Hypothermia – Clinical Advisor

  https://www.clinicaladvisor.com/features/care-for-the-cold-assessment-and-treatment-of-accidental-hypothermia/

  Accidental hypothermia is the most common form of hypothermia encountered in the emergency department. Emergency room encounters for hypothermia are increasing as more individuals search for outdoor activities or engage in winter sports. […] Each year in the United States, approximately 700 people die from accidental primary hypothermia, and about 1500 individuals have hypothermia noted on their death certificate. […] States with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. Cold-related deaths are substantially higher in rural counties rather than urban areas. […] When diagnosing hypothermia, clinicians must also consider underlying etiologies of hypothermia in which the patient has a medical illness or other factor that impairs temperature regulation or predisposes them to heat loss.

• #50 Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes | BMJ Open

  https://bmjopen.bmj.com/content/11/5/e046806

  The present study investigated the incidence of AH, associated comorbidities, and mortality after AH in Denmark from 1995 to 2016. The diagnosis is associated with a high comorbidity burden and a considerable 1-year mortality. […] The mean annual incidence of AH was 4.41.2 per 100000 inhabitants with a range from 2.9 to 6.4 per 100000 inhabitants. […] The overall incidence of AH increased from 2000 to 2016 (absolute increase 0.160.02 per 100000 inhabitants per calendar year, p0.001). […] The annual incidence of AH was 4.31.6 per 100000 in inhabitants from 18 to 20 years, 2.30.55 per 100000 in inhabitants from 21 to 40 years, 4.81.1 per 100000 in inhabitants from 41 to 60 years, 7.22.6 in inhabitants from 61 to 80 years, and 2811 in inhabitants older than 80 years. […] Overall mortality within the first 7days of admission was 11%, increasing to 16% at 30 days, and 27% at 1year. One-year mortality was 22% in patients with primary AH, 26% in patients with AH+2 diagnosis and 35% in patients with 1 diagnosis+AH (p0.001). […] The higher mortality in patients with comorbidities remained unchanged after adjustment for confounding factors.

• #51 Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes | BMJ Open

  https://bmjopen.bmj.com/content/11/5/e046806

  The present study investigated the incidence of AH, associated comorbidities, and mortality after AH in Denmark from 1995 to 2016. The diagnosis is associated with a high comorbidity burden and a considerable 1-year mortality. […] The mean annual incidence of AH was 4.41.2 per 100000 inhabitants with a range from 2.9 to 6.4 per 100000 inhabitants. […] The overall incidence of AH increased from 2000 to 2016 (absolute increase 0.160.02 per 100000 inhabitants per calendar year, p0.001). […] The annual incidence of AH was 4.31.6 per 100000 in inhabitants from 18 to 20 years, 2.30.55 per 100000 in inhabitants from 21 to 40 years, 4.81.1 per 100000 in inhabitants from 41 to 60 years, 7.22.6 in inhabitants from 61 to 80 years, and 2811 in inhabitants older than 80 years. […] Overall mortality within the first 7days of admission was 11%, increasing to 16% at 30 days, and 27% at 1year. One-year mortality was 22% in patients with primary AH, 26% in patients with AH+2 diagnosis and 35% in patients with 1 diagnosis+AH (p0.001). […] The higher mortality in patients with comorbidities remained unchanged after adjustment for confounding factors.

• #52 Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes | BMJ Open

  https://bmjopen.bmj.com/content/11/5/e046806

  The present study investigated the incidence of AH, associated comorbidities, and mortality after AH in Denmark from 1995 to 2016. The diagnosis is associated with a high comorbidity burden and a considerable 1-year mortality. […] The mean annual incidence of AH was 4.41.2 per 100000 inhabitants with a range from 2.9 to 6.4 per 100000 inhabitants. […] The overall incidence of AH increased from 2000 to 2016 (absolute increase 0.160.02 per 100000 inhabitants per calendar year, p0.001). […] The annual incidence of AH was 4.31.6 per 100000 in inhabitants from 18 to 20 years, 2.30.55 per 100000 in inhabitants from 21 to 40 years, 4.81.1 per 100000 in inhabitants from 41 to 60 years, 7.22.6 in inhabitants from 61 to 80 years, and 2811 in inhabitants older than 80 years. […] Overall mortality within the first 7days of admission was 11%, increasing to 16% at 30 days, and 27% at 1year. One-year mortality was 22% in patients with primary AH, 26% in patients with AH+2 diagnosis and 35% in patients with 1 diagnosis+AH (p0.001). […] The higher mortality in patients with comorbidities remained unchanged after adjustment for confounding factors.

• #53 Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a2.htm

  Hypothermia is defined as a core body temperature of 95F (35C) and is caused by environmental exposure, drug intoxication, or metabolic or nervous system dysfunction. Exposure to cold is a leading cause of weather-related mortality and is responsible for approximately twice the number of deaths annually as exposure to heat in the United States. To understand the risk factors for hypothermia-related death and improve prevention efforts, during January 1-April 30, 2014, a period of record low temperatures, the Wisconsin Division of Public Health began active surveillance for hypothermia. […] Hypothermia continues to be an important cause of weather-related death. Key risk factors include drug intoxication, mental illness, and social isolation. State and local health agencies might need to focus outreach on vulnerable populations and target interventions for groups at highest risk for death.

• #54 Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a2.htm

  Hypothermia is defined as a core body temperature of 95F (35C) and is caused by environmental exposure, drug intoxication, or metabolic or nervous system dysfunction. Exposure to cold is a leading cause of weather-related mortality and is responsible for approximately twice the number of deaths annually as exposure to heat in the United States. To understand the risk factors for hypothermia-related death and improve prevention efforts, during January 1-April 30, 2014, a period of record low temperatures, the Wisconsin Division of Public Health began active surveillance for hypothermia. […] Hypothermia continues to be an important cause of weather-related death. Key risk factors include drug intoxication, mental illness, and social isolation. State and local health agencies might need to focus outreach on vulnerable populations and target interventions for groups at highest risk for death.

• #55 Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a2.htm

  During January-April 2014, a total of 27 hypothermia-related deaths occurred in Wisconsin, all of which were investigated by a coroner or medical examiner. […] Hypothermia-related deaths for the United States overall were obtained from CDC’s multiple cause of death files and were defined as any death with an underlying or contributing cause of death from exposure to excessive natural cold. A total of 13,419 deaths occurred during the period, with unadjusted annual rates ranging from 0.3 to 0.5 per 100,000 persons. […] This report highlights previously identified risk factors for fatal hypothermia, including advanced age, male sex, drug intoxication, homelessness, and mental illness. […] Social isolation can be an important factor in hypothermia-related mortality. State and local health agencies might need to target public education and interventions at socially isolated groups, including older persons, the homeless, and those living alone.

• #56 Hypothermia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/770542-overview

  According to current data, states with the highest overall death rates for hypothermia are Alaska, New Mexico, North Dakota, and Montana. […] The greatest number of cases of hypothermia occur in an urban setting and are related to environmental exposure attributed to alcoholism, illicit drug use, or mental illness, often exacerbated by concurrent homelessness. […] A second affected group includes people in an outdoor setting for work or pleasure, including hunters, skiers, climbers, boaters/rafters, and swimmers. […] The US Centers for Disease Control and Prevention (CDC) report the following statistics for deaths by excessive natural cold in the period 1999-2011: Total deaths: 16,911. […] Average deaths per year: 1,301. […] Highest yearly total: 1,536 (2010). […] Lowest yearly total: 1,058 (2006).

• #57 Hypothermia-Related Deaths — Wisconsin, 2014, and United States, 2003–2013

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a2.htm

  Hypothermia is defined as a core body temperature of 95F (35C) and is caused by environmental exposure, drug intoxication, or metabolic or nervous system dysfunction. Exposure to cold is a leading cause of weather-related mortality and is responsible for approximately twice the number of deaths annually as exposure to heat in the United States. To understand the risk factors for hypothermia-related death and improve prevention efforts, during January 1-April 30, 2014, a period of record low temperatures, the Wisconsin Division of Public Health began active surveillance for hypothermia. […] Hypothermia continues to be an important cause of weather-related death. Key risk factors include drug intoxication, mental illness, and social isolation. State and local health agencies might need to focus outreach on vulnerable populations and target interventions for groups at highest risk for death.

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