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Epidemiology and outcomes of children with accidental hypothermia: A propensity-matched study
Abhinav Totapally1, Michael Leoncio, Fernando Beltramo
1From the Florida Atlantic Univeristy (A.T.), Boca Raton, Florida; Division of Critical Care Medicine (M.L., F.B., K.M., A.R., B.R.T.), Nicklaus Children's Hospital, Miami, Florida; and the Herbert Wertheim College of Medicine (M.L., K.M., A.R., B.R.T.), Florida International University, Miami, Florida.
Insights
Accidental hypothermia in hospitalized children significantly increases mortality risk. This condition was disproportionately observed in Southern US states, highlighting regional disparities in pediatric care.
Area of Science:
- Pediatric Medicine
- Epidemiology
- Public Health
Background:
- Accidental hypothermia is a critical condition in children.
- Understanding its epidemiology and outcomes is vital for improving patient care.
- Previous research has not fully elucidated the national scope of this issue in hospitalized children.
Purpose of the Study:
- To investigate the epidemiology of accidental hypothermia in hospitalized children.
- To analyze the outcomes associated with accidental hypothermia in this population.
- To identify demographic and regional factors influencing hypothermia incidence and mortality.
Main Methods:
- Utilized the 2012 Kids' Inpatient Database for national discharge data.
- Employed International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify cases.
- Conducted propensity score matching to compare outcomes between hypothermia and control groups.
Main Results:
- Accidental hypothermia occurred in 1,028 of 1,915,435 pediatric discharges.
- Hypothermia patients were more likely male, infants, and admitted from Southern regions.
- Mortality rates were significantly higher in children with accidental hypothermia (8.5% vs. 0.3%).
Conclusions:
- Accidental hypothermia is a significant independent risk factor for increased mortality in hospitalized children.
- The higher incidence in Southern states warrants further investigation into regional contributing factors.
- Findings underscore the need for targeted prevention and management strategies.
Background:
The purpose of this study was to explore the epidemiology and outcomes of hospitalized children with a diagnosis of accidental hypothermia.
Methods:
The 2012 Kids' Inpatient Database, detailing discharge diagnoses in children admitted to US hospitals, was analyzed using International Classification of Diseases, Ninth Revision, Clinical Modification codes to filter out relevant patients. Children ages 1 month to 17 years were included in the analysis. Demographic and outcome variables in the hypothermia group were compared with the rest of the patients. In a separate analysis, children with hypothermia were matched 1:1 using a correlative propensity score using sex, age, hospital region, income quartiles, race, ventilation status, coagulopathy, drowning, and All Patient Refined Diagnosis Related Groups severity score and their outcomes were compared with controls. The sample data were weighted to get a national estimate.
Results:
Accidental hypothermia was present in 1,028 cases out of 1,915,435 discharges. Children with hypothermia were more likely to be males (54.7% vs. 50.9%; p < 0.05) and infants (32.6% vs. 17.5%); they were less likely to be teens (30% vs. 37.8%). Children with hypothermia were more likely to be admitted in the Southern region (48.3% vs. 38.4%; p < 0.05) and have a higher mortality rate compared to all other discharges (8.5% vs. 0.3%; p < 0.05) or when compared with the matched controls (8.9% vs. 4.4%).
Conclusions:
The diagnosis of accidental hypothermia significantly increased mortality in hospitalized children. Interestingly, accidental hypothermia was more common in Southern states compared to the other areas of the United States.
Level Of Evidence:
Prognostic/epidemiological study, level III.
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