An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature.

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License: CC BY 4.0
Serval ID
serval:BIB_22084A85EF99
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature.
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
Author(s)
Pasquier M., Carron P.N., Rodrigues A., Dami F., Frochaux V., Sartori C., Deslarzes T., Rousson V.
ISSN
1757-7241 (Electronic)
ISSN-L
1757-7241
Publication state
Published
Issued date
06/06/2019
Peer-reviewed
Oui
Volume
27
Number
1
Pages
60
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is < 35-32 °C, for stage 2 is < 32-28 °C, for stage 3 is < 28-24 °C, and for stage 4 is below 24 °C. Our previous study using 183 case reports from the literature showed that the measured temperature only corresponded to the clinical stage in the Swiss staging model in approximately 50% of cases. This study, however, included few patients with moderate hypothermia. We aimed to expand this database by adding cases of hypothermic patients admitted to hospital to perform a more comprehensive evaluation of the staging model.
We retrospectively included patients aged ≥18 y admitted to hospital between 1.1.1994 and 15.7.2016 with a core temperature below 35 °C. We added the cases identified through our previously published literature review to estimate the percentage of those patients who were correctly classified and compare the theoretical with the observed temperature ranges for each clinical stage.
We included 305 cases (122 patients from the hospital sampling and the 183 previously published). Using the theoretically derived temperature ranges for clinical stages resulted in 185/305 (61%) patients being assigned to the correct temperature range. Temperature was overestimated using the clinical stage in 55/305 cases (18%) and underestimated in 65/305 cases (21%); important overlaps in temperature existed among the four stage groups. The optimal temperature thresholds for discriminating between the four stages (32.1 °C, 27.5 °C, and 24.1 °C) were close to those proposed historically (32 °C, 28 °C, and 24 °C).
Our results provide further evidence of the relationship between the clinical state of patients and their temperature. The historical proposed temperature thresholds were almost optimal for discriminating between the different stages. Adding overlapping temperature ranges for each clinical stage might help clinicians to make appropriate decisions when using clinical signs to infer temperature. An update of the Swiss staging model for hypothermia including our methodology and findings could positively impact clinical care and future research.
Keywords
Adolescent, Adult, Aged, Blood Alcohol Content, Blood Pressure, Body Temperature/physiology, Emergency Service, Hospital, Female, Glasgow Coma Scale, Hospitalization, Humans, Hypothermia, Induced/nursing, Hypothermia, Induced/standards, Male, Middle Aged, Retrospective Studies, Rewarming/methods, Young Adult, Cardiac arrest, Core temperature, Emergency medicine, Hypothermia, Swiss staging
Pubmed
Web of science
Open Access
Yes
Create date
24/06/2019 9:07
Last modification date
18/09/2019 6:10
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