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Impact of Housing Status on Mortality Following Frostbite Injury: A Multicenter Cohort Analysis
Alexandra M Lacey1,2, Emily Colonna3, Rediat Tilahun3
1Department of Surgery, Regions Hospital Burn Center, Saint Paul, MN 55101, United States.
Summary
Unhoused individuals with frostbite injury have similar mortality rates but die younger than housed patients. Targeted healthcare strategies are needed to address socioeconomic disparities and improve outcomes for unhoused persons.
Area of Science:
- Public Health
- Trauma Surgery
- Social Determinants of Health
Background:
- Frostbite disproportionately affects unhoused populations due to extreme temperature exposure.
- Socioeconomic factors significantly influence health outcomes and vulnerability to injury.
Purpose of the Study:
- To investigate the mortality risk associated with frostbite injury in unhoused versus housed individuals.
- To identify predictors of mortality following frostbite injury, considering housing status and other confounders.
Main Methods:
- A longitudinal cohort study analyzed data from 933 frostbite patients from two high-volume centers, linked to state health records.
- Cox proportional hazards regression was used to adjust for confounders including age, sex, race, alcohol, and drug use.
- Follow-up data tracked mortality over time, comparing outcomes between unhoused and housed patient groups.
Main Results:
- Nearly one-third of frostbite patients were unhoused at the time of injury.
- Overall mortality was 19.8%; rates were similar between unhoused (19.7%) and housed (20.2%) patients.
- Unhoused individuals died at significantly younger ages, and age was a significant predictor of mortality.
Conclusions:
- While overall mortality risk is similar, unhoused frostbite patients face a higher risk of premature death.
- Living situation and drug use showed a trend toward increased mortality, underscoring the impact of social determinants.
- Targeted healthcare interventions are crucial to mitigate socioeconomic disparities and improve survival for unhoused individuals with frostbite.
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