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An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature

BACKGROUND: The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35–32 °C, for stage 2 is < 32–28 °C, for stage 3 is < 28–24 °C, and for stage 4 is bel...

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Autores principales: Pasquier, M., Carron, P. N., Rodrigues, A., Dami, F., Frochaux, V., Sartori, C., Deslarzes, T., Rousson, V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555718/
https://www.ncbi.nlm.nih.gov/pubmed/31171019
http://dx.doi.org/10.1186/s13049-019-0636-0
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author Pasquier, M.
Carron, P. N.
Rodrigues, A.
Dami, F.
Frochaux, V.
Sartori, C.
Deslarzes, T.
Rousson, V.
author_facet Pasquier, M.
Carron, P. N.
Rodrigues, A.
Dami, F.
Frochaux, V.
Sartori, C.
Deslarzes, T.
Rousson, V.
author_sort Pasquier, M.
collection PubMed
description BACKGROUND: The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35–32 °C, for stage 2 is < 32–28 °C, for stage 3 is < 28–24 °C, and for stage 4 is below 24 °C. Our previous study using 183 case reports from the literature showed that the measured temperature only corresponded to the clinical stage in the Swiss staging model in approximately 50% of cases. This study, however, included few patients with moderate hypothermia. We aimed to expand this database by adding cases of hypothermic patients admitted to hospital to perform a more comprehensive evaluation of the staging model. METHODS: We retrospectively included patients aged ≥18 y admitted to hospital between 1.1.1994 and 15.7.2016 with a core temperature below 35 °C. We added the cases identified through our previously published literature review to estimate the percentage of those patients who were correctly classified and compare the theoretical with the observed temperature ranges for each clinical stage. RESULTS: We included 305 cases (122 patients from the hospital sampling and the 183 previously published). Using the theoretically derived temperature ranges for clinical stages resulted in 185/305 (61%) patients being assigned to the correct temperature range. Temperature was overestimated using the clinical stage in 55/305 cases (18%) and underestimated in 65/305 cases (21%); important overlaps in temperature existed among the four stage groups. The optimal temperature thresholds for discriminating between the four stages (32.1 °C, 27.5 °C, and 24.1 °C) were close to those proposed historically (32 °C, 28 °C, and 24 °C). CONCLUSIONS: Our results provide further evidence of the relationship between the clinical state of patients and their temperature. The historical proposed temperature thresholds were almost optimal for discriminating between the different stages. Adding overlapping temperature ranges for each clinical stage might help clinicians to make appropriate decisions when using clinical signs to infer temperature. An update of the Swiss staging model for hypothermia including our methodology and findings could positively impact clinical care and future research.
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spelling pubmed-65557182019-06-10 An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature Pasquier, M. Carron, P. N. Rodrigues, A. Dami, F. Frochaux, V. Sartori, C. Deslarzes, T. Rousson, V. Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35–32 °C, for stage 2 is < 32–28 °C, for stage 3 is < 28–24 °C, and for stage 4 is below 24 °C. Our previous study using 183 case reports from the literature showed that the measured temperature only corresponded to the clinical stage in the Swiss staging model in approximately 50% of cases. This study, however, included few patients with moderate hypothermia. We aimed to expand this database by adding cases of hypothermic patients admitted to hospital to perform a more comprehensive evaluation of the staging model. METHODS: We retrospectively included patients aged ≥18 y admitted to hospital between 1.1.1994 and 15.7.2016 with a core temperature below 35 °C. We added the cases identified through our previously published literature review to estimate the percentage of those patients who were correctly classified and compare the theoretical with the observed temperature ranges for each clinical stage. RESULTS: We included 305 cases (122 patients from the hospital sampling and the 183 previously published). Using the theoretically derived temperature ranges for clinical stages resulted in 185/305 (61%) patients being assigned to the correct temperature range. Temperature was overestimated using the clinical stage in 55/305 cases (18%) and underestimated in 65/305 cases (21%); important overlaps in temperature existed among the four stage groups. The optimal temperature thresholds for discriminating between the four stages (32.1 °C, 27.5 °C, and 24.1 °C) were close to those proposed historically (32 °C, 28 °C, and 24 °C). CONCLUSIONS: Our results provide further evidence of the relationship between the clinical state of patients and their temperature. The historical proposed temperature thresholds were almost optimal for discriminating between the different stages. Adding overlapping temperature ranges for each clinical stage might help clinicians to make appropriate decisions when using clinical signs to infer temperature. An update of the Swiss staging model for hypothermia including our methodology and findings could positively impact clinical care and future research. BioMed Central 2019-06-06 /pmc/articles/PMC6555718/ /pubmed/31171019 http://dx.doi.org/10.1186/s13049-019-0636-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Pasquier, M.
Carron, P. N.
Rodrigues, A.
Dami, F.
Frochaux, V.
Sartori, C.
Deslarzes, T.
Rousson, V.
An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title_full An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title_fullStr An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title_full_unstemmed An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title_short An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature
title_sort evaluation of the swiss staging model for hypothermia using hospital cases and case reports from the literature
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555718/
https://www.ncbi.nlm.nih.gov/pubmed/31171019
http://dx.doi.org/10.1186/s13049-019-0636-0
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