serval:BIB_22084A85EF99
An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature.
10.1186/s13049-019-0636-0
000470761200001
31171019
Pasquier
M.
author
Carron
P.N.
author
Rodrigues
A.
author
Dami
F.
author
Frochaux
V.
author
Sartori
C.
author
Deslarzes
T.
author
Rousson
V.
author
article
2019-06-06
Scandinavian journal of trauma, resuscitation and emergency medicine
1757-7241
1757-7241
journal
27
1
60
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.
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
eng
60_published
true
peer-reviewed
Publication types: Journal Article
Publication Status: epublish
University of Lausanne
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