Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes

OBJECTIVES: To investigate the incidence of accidental hypothermia (AH) in a nationwide registry and the associated outcomes. DESIGN: Nationwide retrospective cohort study PARTICIPANTS AND SETTINGS: All patients at least 18 years old, admitted to hospitals in Denmark with a diagnosis of AH, with an...

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Autores principales: Wiberg, Sebastian, Mortensen, Asmus Friborg, Kjaergaard, Jesper, Hassager, Christian, Wanscher, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169477/
https://www.ncbi.nlm.nih.gov/pubmed/34059513
http://dx.doi.org/10.1136/bmjopen-2020-046806
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author Wiberg, Sebastian
Mortensen, Asmus Friborg
Kjaergaard, Jesper
Hassager, Christian
Wanscher, Michael
author_facet Wiberg, Sebastian
Mortensen, Asmus Friborg
Kjaergaard, Jesper
Hassager, Christian
Wanscher, Michael
author_sort Wiberg, Sebastian
collection PubMed
description OBJECTIVES: To investigate the incidence of accidental hypothermia (AH) in a nationwide registry and the associated outcomes. DESIGN: Nationwide retrospective cohort study PARTICIPANTS AND SETTINGS: All patients at least 18 years old, admitted to hospitals in Denmark with a diagnosis of AH, with an International Classification of Diseases, 10th edition code of T689, from January 1996 to November 2016. Other recorded diagnoses were included in the analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was 1-year mortality. RESULTS: During the inclusion period, 5242 patients were admitted with a diagnosis of AH, corresponding to a mean annual incidence of 4.4±1.2 (range by calendar year: 2.9–6.4) per 100 000 inhabitants. A total of 2230 (43%) had AH recorded as the primary diagnosis without any recorded secondary diagnoses (primary AH), 1336 (25%) had AH recorded as the primary diagnosis with other recorded secondary diagnoses (AH+2° diagnosis), and 1676 (32%) had AH recorded as a secondary diagnosis with another recorded primary diagnosis (1° diagnosis+AH). Alcohol intoxication was the most common diagnosis associated with AH. Overall 1-year mortality was 27%. In patients with primary AH, 1-year mortality was 22%, compared with 26% in patients with secondary AH type I, and 35% in patients with secondary AH type II (p(log-rank)<0.001). CONCLUSIONS: 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. In the high proportion of patients with associated comorbidities, establishing whether AH or the comorbidities are the drivers of mortality remains difficult. This complicates our understanding of AH and makes it difficult to find modifiable factors associated with both AH and outcomes. Future prospective studies are needed elucidate the causal relationship between AH and associated comorbidities.
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spelling pubmed-81694772021-06-17 Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes Wiberg, Sebastian Mortensen, Asmus Friborg Kjaergaard, Jesper Hassager, Christian Wanscher, Michael BMJ Open Emergency Medicine OBJECTIVES: To investigate the incidence of accidental hypothermia (AH) in a nationwide registry and the associated outcomes. DESIGN: Nationwide retrospective cohort study PARTICIPANTS AND SETTINGS: All patients at least 18 years old, admitted to hospitals in Denmark with a diagnosis of AH, with an International Classification of Diseases, 10th edition code of T689, from January 1996 to November 2016. Other recorded diagnoses were included in the analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was 1-year mortality. RESULTS: During the inclusion period, 5242 patients were admitted with a diagnosis of AH, corresponding to a mean annual incidence of 4.4±1.2 (range by calendar year: 2.9–6.4) per 100 000 inhabitants. A total of 2230 (43%) had AH recorded as the primary diagnosis without any recorded secondary diagnoses (primary AH), 1336 (25%) had AH recorded as the primary diagnosis with other recorded secondary diagnoses (AH+2° diagnosis), and 1676 (32%) had AH recorded as a secondary diagnosis with another recorded primary diagnosis (1° diagnosis+AH). Alcohol intoxication was the most common diagnosis associated with AH. Overall 1-year mortality was 27%. In patients with primary AH, 1-year mortality was 22%, compared with 26% in patients with secondary AH type I, and 35% in patients with secondary AH type II (p(log-rank)<0.001). CONCLUSIONS: 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. In the high proportion of patients with associated comorbidities, establishing whether AH or the comorbidities are the drivers of mortality remains difficult. This complicates our understanding of AH and makes it difficult to find modifiable factors associated with both AH and outcomes. Future prospective studies are needed elucidate the causal relationship between AH and associated comorbidities. BMJ Publishing Group 2021-05-31 /pmc/articles/PMC8169477/ /pubmed/34059513 http://dx.doi.org/10.1136/bmjopen-2020-046806 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Emergency Medicine
Wiberg, Sebastian
Mortensen, Asmus Friborg
Kjaergaard, Jesper
Hassager, Christian
Wanscher, Michael
Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title_full Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title_fullStr Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title_full_unstemmed Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title_short Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes
title_sort accidental hypothermia in denmark: a nationwide cohort study of incidence and outcomes
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169477/
https://www.ncbi.nlm.nih.gov/pubmed/34059513
http://dx.doi.org/10.1136/bmjopen-2020-046806
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