Beirão Tiago, Jesus Guilherme, Pereira Inês Pinto, Severo Milton, Cochicho Joana
Rheumatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Internal Medicine Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Porto Biomed J. 2025 Sep 10;10(5):e300. doi: 10.1097/j.pbj.0000000000000300. eCollection 2025 Sep-Oct.
Hypothermia as the major clinical feature at emergency admission poses a low-frequency yet complex and life-threatening challenge. Limited knowledge about its morbidity, mortality, and influencing factors contributes to the absence of standardized guidelines for rewarming treatments. This retrospective study, the first of its kind in Portugal, aims to fill this gap by examining hypothermic patients in a temperate climate, exploring rewarming treatments, mortality factors, and complications.
Conducted at the Emergency Department of Centro Hospitalar Vila Nova de Gaia/Espinho, the study spanned from January 2008 to December 2020. Sixty-two patients with body temperatures below 35ºC were included. Data collection focused on patient background, clinical presentation, hypothermia mechanism, reperfusion treatment, and laboratory results. Clinical infection was defined based on symptoms and imaging findings.
The study revealed a diverse cohort, with an average age of 82 and a mortality rate of 33.9%. Clinical infection was prevalent in 51.6% of patients, mostly respiratory (59.4%). Rewarming treatments varied, and no specific method showed significant advantage. Complications included rhabdomyolysis, and late deaths were primarily attributed to infectious diseases, particularly pneumonia.
Taking into account its high mortality rate, accidental hypothermia, demands further research and multicenter data collection for evidence-based treatment strategies. Clinical infection emerged as a significant factor in mortality, prompting a call for increased attention to infectious disease identification and treatment during hypothermic episodes.
低温作为急诊入院时的主要临床特征，是一个虽不常见但复杂且危及生命的挑战。关于其发病率、死亡率及影响因素的了解有限，导致缺乏复温治疗的标准化指南。这项葡萄牙首例的回顾性研究旨在通过对温带气候下的低温患者进行检查，探索复温治疗、死亡因素及并发症，填补这一空白。
该研究在新盖亚/埃斯皮尼奥中心医院急诊科开展，时间跨度为2008年1月至2020年12月。纳入62例体温低于35ºC的患者。数据收集集中在患者背景、临床表现、低温机制、再灌注治疗及实验室检查结果。临床感染根据症状和影像学检查结果定义。
研究显示这是一个多样化的队列，平均年龄82岁，死亡率为33.9%。51.6%的患者存在临床感染，主要为呼吸道感染（59.4%）。复温治疗方法多样，没有哪种特定方法显示出显著优势。并发症包括横纹肌溶解，晚期死亡主要归因于传染病，尤其是肺炎。
考虑到意外低温的高死亡率，需要进一步研究并进行多中心数据收集，以制定基于证据的治疗策略。临床感染成为死亡率的一个重要因素，这促使人们呼吁在低温发作期间更加关注传染病的识别和治疗。
