Mégarbane B, Axler O, Chary I, Pompier R, Brivet F G
Department of Medical Intensive Care Unit and Medical Emergency, Antoine Béclère Hospital, Clamart, France.
Intensive Care Med. 2000 Dec;26(12):1843-9. doi: 10.1007/s001340000702.
To describe patients admitted to intensive care unit (ICU) for hypothermia, evaluate prognostic factors, and test the hypothesis that patients found indoors have a worse outcome.
Retrospective clinical investigation in a medical ICU.
Eighty-one consecutive patients admitted to ICU, with a body temperature of 35 degrees C or lower and rewarmed passively or with minimally invasive techniques, over a 17-year period.
Patients were analyzed by age, gender, and causes of hypothermia and split into two groups (indoors and outdoors), according to the location where hypothermia occurred. Prognostic factors were determined by univariate method and stepwise logistic regression. The major complications were acute renal failure (43 %), aspiration pneumonia (22 %), rhabdomyolysis (22 %), and acute respiratory distress syndrome (12%). Principal comorbidities in the outdoor patients (21%) were alcohol and drug intoxication, and those in the indoor patients (79 %) were sepsis and neuropsychiatric disorders. Stepwise logistic regression identified two variables predictive of death: illness severity at admission (SAPS II > or = 40) and the location where hypothermia occurred (indoors versus outdoors).
With equivalent body temperature, patients found indoors were more severely affected and died more frequently than those found outdoors.
描述因体温过低入住重症监护病房（ICU）的患者情况，评估预后因素，并验证在室内发现的患者预后较差这一假设。
在一家医疗ICU进行的回顾性临床研究。
在17年期间，连续81例体温为35摄氏度或更低且通过被动复温或微创技术复温的患者入住ICU。
根据体温过低发生的地点，按年龄、性别和体温过低的原因对患者进行分析，并分为两组（室内和室外）。通过单因素方法和逐步逻辑回归确定预后因素。主要并发症为急性肾衰竭（43%）、吸入性肺炎（22%）、横纹肌溶解（22%）和急性呼吸窘迫综合征（12%）。室外患者（21%）的主要合并症为酒精和药物中毒，室内患者（79%）的主要合并症为败血症和神经精神疾病。逐步逻辑回归确定了两个预测死亡的变量：入院时的疾病严重程度（简化急性生理学评分II≥40）和体温过低发生的地点（室内与室外）。
在体温相当的情况下，室内发现的患者比室外发现的患者受影响更严重，死亡频率更高。
