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Hypothermia and Mortality Among Children in the Emergency Department

Lucy Campbell1, Aarthi Kottapalli1, Leslie Hueschen2

  • 1Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Pediatrics
|May 19, 2026
PubMed

Insights

Hypothermia in children presenting to the emergency department (ED) is a significant risk factor for mortality. This study found hypothermia independently associated with increased in-hospital death across various pediatric subgroups.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Research
  • Public Health

Background:

  • Hypothermia is a known risk factor for adverse outcomes in pediatric sepsis and trauma.
  • The overall association between hypothermia and mortality in all children in the emergency department (ED) remains unclear.

Purpose of the Study:

  • To investigate the association between hypothermia and in-hospital mortality among children presenting to the ED.
  • To determine if hypothermia is an independent predictor of mortality in pediatric ED encounters.

Main Methods:

  • Retrospective multicenter cohort study using the 2012-2021 Pediatric Emergency Care Applied Research Network registry.
  • Inclusion of pediatric patients (<18 years) presenting to the ED.
  • Analysis of first-recorded temperature (hypothermia ≤36 °C, euthermia, or fever ≥38 °C) and in-hospital mortality using multivariable logistic regression.

Main Results:

  • The study analyzed over 5.3 million pediatric ED encounters.
  • Hypothermia was present in 3.0% of encounters and was associated with a significantly increased odds of in-hospital mortality (OR 20.15).
  • This association persisted across subgroups, including patients with and without medical complexity and trauma.

Conclusions:

  • Hypothermia is an independent risk factor for mortality in children presenting to the ED.
  • Identifying hypothermia can help identify children at higher risk for poor outcomes.
  • Further research may explore interventions to mitigate hypothermia-related mortality.
Abstract

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