Kuht James A, Woods D, Hollis S
jHub, Joint Forces Command (JFC), Aldgate Tower, London, UK
Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
J R Army Med Corps. 2019 Dec;165(6):400-404. doi: 10.1136/jramc-2018-000992. Epub 2018 Oct 25.
Non-freezing cold injury (NFCI) occurs when the peripheral tissue is cooled sufficiently that damage occurs, but not to the point of tissue freezing. Historically, the phenotype of the injuries studied was often severe, and it is unclear whether knowledge gained from these cases is entirely relevant to the frequently subtle injuries seen today.
We therefore sought to characterise a recent case series of 100 patients referred with suspected NFCI to a military UK NFCI clinic. Their demographics, medical history and situational risk factors leading to their injuries were analysed, and comparison was made between those subsequently diagnosed with NFCI (n=76) and those receiving alternate diagnoses (n=24).
Statistically significant predisposing factors for NFCI in the UK service personnel (SP) were being of African-Caribbean ethnicity and having a short duration of service in the Armed Forces. Past or current smoking was not identified as a risk factor. Injuries were almost always suffered on training exercises (most commonly in the UK); being generally cold and being on static duties were statistically significant situational risk factors. Non-significant trends of risk were also found for having wet clothing, wet boots and immersion. Self-reported dehydration was not found to be a risk factor for NFCI.
Our demographic findings are in general agreement with those of previous studies. Our situational risk factor findings, however, highlight a pattern of NFCI risk factors to the modern UK SP: winter training exercises, when troops are generally cold and extremities often wet, with static duties frequently implicated in the disease mechanism.
非冻结性冷损伤（NFCI）是指外周组织被充分冷却至发生损伤，但未达到组织冻结程度时所出现的情况。从历史上看，所研究损伤的表型往往较为严重，而从这些病例中获得的知识是否完全适用于如今常见的轻微损伤尚不清楚。
因此，我们试图对近期转诊至英国一家军事NFCI诊所的100例疑似NFCI患者的病例系列进行特征描述。分析了他们的人口统计学特征、病史以及导致其损伤的情境风险因素，并对随后被诊断为NFCI的患者（n = 76）和接受其他诊断的患者（n = 24）进行了比较。
在英国军人（SP）中，NFCI具有统计学意义的易感因素是非洲 - 加勒比裔以及在武装部队中的服役时间较短。既往或当前吸烟未被确定为风险因素。损伤几乎总是在训练演习中发生（最常见于英国）；一般寒冷和执行静态任务是具有统计学意义的情境风险因素。对于衣物潮湿、靴子潮湿和浸泡，也发现了无统计学意义的风险趋势。自我报告的脱水未被发现是NFCI的风险因素。
我们的人口统计学研究结果总体上与先前的研究一致。然而，我们关于情境风险因素的研究结果突出了现代英国军人NFCI风险因素的一种模式：冬季训练演习期间，此时部队普遍寒冷且四肢经常潮湿，静态任务频繁涉及疾病机制。
