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Hypothermia increases the chances of dying among people admitted to the hospital with major trauma

Current trauma resuscitation guidelines call for aggressive pre-hospital and in-hospital measures to prevent hypothermia in severely injured patients (for example, use of warming blankets and warmed intravenous fluids). However, these guidelines are based on limited patient series, and some studies suggest that applying hypothermia as a therapeutic measure may benefit selected trauma patients. A new study, supported in part by the Agency for Healthcare Research and Quality (HS13628), clarifies the role of hypothermia in the outcomes of trauma patients. Henry E. Wang, M.D., M.P.H., University of Pittsburgh School of Medicine, and colleagues found that patients with major trauma who were admitted to the hospital with hypothermia were more likely to die than those who were admitted without hypothermia.

Researchers retrospectively analyzed deaths among all trauma patients 16 years and older who were seen at trauma centers in Pennsylvania in between 2000 and 2002. Of 38,520 patients, 1,921 (5 percent) were hypothermic upon hospital admission. Overall, hypothermia independently tripled the chances of death for all these patients. Among patients with isolated severe head injury, hypothermia was associated with more than twice the risk of death.

More details are in "Admission hypothermia and outcome after major trauma," by Dr. Wang, Clifton W. Callaway, M.D., Ph.D., Andrew B. Peitzman, M.D., and Samuel A. Tisherman, M.D., in the June 2005 Critical Care Medicine 33(6), pp. 1296-1301.

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