Frostbite injuries in Refugees: Analysis of delayed presentation, amputation risk, and clinical outcomes

Frostbite injuries remain a significant clinical problem, particularly in populations exposed to harsh environmental conditions and limited access to healthcare. This study aimed to evaluate the clinical characteristics, risk factors, and outcomes of frostbite cases managed at a tertiary care center.

This retrospective study included 159 patients diagnosed with frostbite over five years. Demographic, clinical, and laboratory data were recorded for all patients. Cases were classified according to frostbite severity. Statistical analyses were performed using SPSS software, with a significance threshold set at p < 0.05.

The majority of patients were young males (97.5%), and a large proportion consisted of refugees. Most cases were classified as fourth-degree frostbite (77.4%). The overall amputation rate was 76.1%. The strongest predictors of amputation were higher frostbite grade (p < 0.001), hypotension at admission (p < 0.001), elevated white blood cell count (p = 0.006), and greater TBSA involvement (p = 0.040). Refugee status was also associated with increased amputation risk (p = 0.035). The mean hospital length of stay was 14.3 ± 7.3 days, which was higher than values reported in the literature, largely due to delayed hospital presentation.

Frostbite injuries in this cohort were associated with high amputation rates. Delayed presentation and advanced-stage injuries appear to be the main drivers of poor clinical outcomes. Early presentation, prompt diagnosis, and timely initiation of appropriate treatment remain critical in reducing morbidity and improving overall outcomes.