Department of Surgery, Division of Trauma and Surgical Critical Care, The Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Pediatr Crit Care Med. 2010 Mar;11(2):199-204. doi: 10.1097/PCC.0b013e3181b80500.
Hypothermia is an independent predictor of mortality in adult trauma studies. However, the impact of hypothermia on the pediatric trauma population has not been described. The purpose of this study is to evaluate hypothermia as a cofactor to mortality, complications, and among survivors, hospital length of stay parameters in the pediatric trauma population.
Retrospective review of a prospectively collected database (National Trauma Registry of the American College of Surgeons) over a 5-yr period (July 2002 to June 2007).
A rural, level I trauma center.
One thousand six hundred twenty-nine pediatric patients admitted with a traumatic injury.
None.
Multivariate regression models were used to evaluate the association of hypothermia with mortality, infectious complications, organ dysfunction, and among survivors, hospital length of stay parameters. Of 1,629 pediatric trauma patients admitted, 182 (11.1%) patients were hypothermic (temperature below 36 degrees C) on admission. Hypothermia had an adjusted odds ratio (AOR) of 2.41 (95% confidence interval [CI], 1.12-5.22, p = .025) for mortality. After controlling for covariates, hypothermia had associations with developing pneumonia (AOR, 0.185, 95% CI, 0.040-0.853; p = .031) and a bleeding diathesis (AOR, 3.14, 95% CI, 1.04-9.44; p = .042). The median days in the hospital, intensive care unit (ICU), and ventilator were longer in the hypothermic cohort; however, after controlling for covariates, hypothermia was not associated with differences in hospital days, ICU days, or ventilator days.
Hypothermia is a common problem at admission among pediatric trauma patients. Hypothermia is associated with an increase in the odds of death and the development of a bleeding diathesis, while having decreased odds for developing pneumonia. While the length of stay indicators were longer in the hypothermic cohort among survivors, no significant association was noted with hypothermia for hospital, ICU, or ventilator days after controlling for confounders.
体温过低是成人创伤研究中死亡率的独立预测因子。然而，体温过低对儿科创伤人群的影响尚未描述。本研究旨在评估体温过低作为死亡率、并发症的合并因素，以及在儿科创伤人群中幸存者的住院时间参数。
对美国外科医师学院国家创伤登记处（National Trauma Registry）在 5 年期间（2002 年 7 月至 2007 年 6 月）前瞻性收集的数据库进行回顾性分析。
农村一级创伤中心。
1629 名因创伤性损伤入院的儿科患者。
无。
使用多元回归模型评估体温过低与死亡率、感染性并发症、器官功能障碍以及幸存者的住院时间参数之间的关系。在 1629 名儿科创伤患者中，182 名（11.1%）患者入院时体温过低（体温低于 36°C）。体温过低的调整比值比（OR）为 2.41（95%置信区间[CI]，1.12-5.22，p=0.025），死亡率更高。在控制了协变量后，体温过低与肺炎的发生有关（OR，0.185，95%CI，0.040-0.853；p=0.031）和出血倾向（OR，3.14，95%CI，1.04-9.44；p=0.042）。体温过低组的住院天数、重症监护病房（ICU）天数和呼吸机天数中位数较长；然而，在控制了协变量后，体温过低与住院天数、ICU 天数或呼吸机天数无显著相关性。
体温过低是儿科创伤患者入院时常见的问题。体温过低与死亡风险增加和出血倾向发展有关，而肺炎发生的可能性降低。虽然幸存者中体温过低组的住院时间指标较长，但在控制了混杂因素后，体温过低与住院时间、ICU 时间或呼吸机时间无显著相关性。
