• Helge Brändström, Göran Johansson, Gordon G Giesbrecht, Karl-Axel Ängquist, and Michael F Haney.
• Department of Surgical and Perioperative Sciences, Anesthesia and Intensive Care Medicine, Faculty of Medicine, Umeå University, S-901 85 Umeå, Sweden. helge.brandstrom@vll.se.
• Scand J Trauma Resus. 2014 Jan 1;22:6.

BackgroundCold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region.MethodsIn this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning. Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32°C), moderate (31.9 - 28°C) and severe (<28°C), hypothermia as well as for frostbite and cold-water drowning.ResultsFrom the 362 cases, average annual incidences for hypothermia, frostbite, and cold-water drowning were estimated to be 3.4/100,000, 1.5/100,000, and 0.8/100,000 inhabitants, respectively. Annual frequencies for hypothermia hospitalizations increased by approximately 3 cases/year during the study period. Twenty percent of the hypothermia cases were mild, 40% moderate, and 24% severe. For 12%, the lowest documented core temperature was 35°C or higher, for 4% there was no temperature documented. Body core temperature was seldom measured in pre-hospital locations. Of 362 cold injury admissions, 17 (5%) died in hospital related to their injuries. Associated co-factors and co-morbidities included ethanol consumption, dementia, and psychiatric diagnosis.ConclusionsThe incidence of accidental hypothermia seems to be increasing in this studied sub-arctic region. Likely associated factors are recognized (ethanol intake, dementia, and psychiatric diagnosis).

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