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. 2016 Jun 30;29(2):103-107.

Factors at scene and in transfer related to the development of hypothermia in major burns

J E Steele  1 , J L Atkins  2 , M P Vizcaychipi  3
Affiliations

Factors at scene and in transfer related to the development of hypothermia in major burns

J E Steele et al. Ann Burns Fire Disasters. .

Abstract
in English, French

There is a paucity of evidence regarding incidence and causes of hypothermia in patients with major burns and its impact on outcomes. This paper identifies contributing factors to hypothermia and its relationship with the severity of physiological scoring systems on admission to a tertiary centre. Patients with burns >20% TBSA admitted between March 2010 and July 2013 comprised this retrospective survey. Data relating to causative factors at time of burn, during transfer, physiological outcome scores (BOBI, SOFA, RTS and APACHE II), length of hospital stay and mortality were collected. SPSS statistical software was used for analysis. The study included 31 patients (medians: age 32 years, burn size 30% TBSA). 13% (n=4) of patients died during hospital admission. 42% (n=13) of patients had a temperature <36.0C on arrival. Temperature on arrival at the burns centre was related to the severity of all physiological scores (p=<0.001). There was no difference between groups in terms of mortality in hospital (p=0.151) or length of hospital stay (p=0.547). Our results show that hypothermia is related to burn severity and patient physiological status. They do not show a relationship between hypothermia and external factors at the time of the burn. This paper prompts further investigation into the prevention of hypothermia in patients with major burns.

Il n’existe que peu de données sur l’incidence et les causes de survenue d’une hypothermie chez les brûlés, ni de son incidence sur le devenir. Cette étude répertorie les facteurs contribuant à l’hypothermie à l’admission dans un centre de référence et sa relation avec les scores de gravité initiaux. Cette étude rétrospective a concerné les patients brûlés sur plus de 20% de SCT admis entre mars 2010 et juillet 2013. Les données concernant les causes d’hypothermie au moment de la brûlure et pendant le transfert, les scores de gravité (BOBI, SOFA, RTS et APACHE II), la durée de séjour et la mortalité ont été relevées. Trente et un dossiers ont été étudiés (âge médian 32 ans, surface brûlée 30%). Quatre (13%) d’ente eux décédés. Treize (42%) avait une température <36°C à l’admission et il existait une corrélation entre la température et les scores de gravité (p<0.001). Il n’y avait pas de différence en termes de mortalité ni de durée de séjour. Cette étude montre que l’hypothermie est corrélée à la gravité de la brûlure et à la gravité générale des patients. On ne retrouve pas de relation entre les facteurs environnementaux au moment de la brûlure et l’hypothermie. Des données supplémentaires sont nécessaires pour la prévention de l’hypothermie liée à la brûlure.

Keywords: burns; hypothermia; intensive care; outcome; transfer.

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Figures

Fig. 1
Fig. 1. Included and excluded patients (CONSORT flow diagram).
Table I
Table I. Patient demographics
Table II
Table II. Relationships between transfer time and distance and temperature on arrival at referring hospital and Chelsea and Westminster
Table III
Table III. Modes of transport and relationships with hypothermia on arrival at referring hospital and Chelsea and Westminster
See this image and copyright information in PMC

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