{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T21:43:18Z","timestamp":1783028598341,"version":"3.54.6"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":300,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The recommendation that patients with accidental hypothermia should be transported to specialized centers that can provide extracorporeal life support has not been validated, and the efficacy remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter retrospective cohort study of patients with a body temperature of \u226435\u00b0C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into two groups based on the point of care delivery: critical care medical center (CCMC) or non\u2010CCMC. The primary outcome of this study was in\u2010hospital death. In\u2010hospital death was compared using a multivariable logistic regression analysis. Subgroup analyses were carried out according to patients with severe hypothermia (&lt;28\u00b0C) or systolic blood pressure (sBP) of &lt;90\u00a0mmHg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 537 patients were included, 413 patients (76.9%) in the CCMC group and 124 patients (23.1%) in the non\u2010CCMC group. The in\u2010hospital death rate was lower in the CCMC group than in the non\u2010CCMC group (22.3% versus 31.5%,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The multivariable logistic regression analysis showed that the adjusted odds ratio (AOR) of the CCMC group was 0.54 (95% confidence interval, 0.32\u20130.90). In subgroup analyses, patients with systolic blood pressure &lt;90\u00a0mmHg in the CCMC group were less likely to experience in\u2010hospital death (AOR 0.36; 95% CI, 0.23\u20130.56). However, no such association was observed among patients with severe hypothermia (AOR 1.08; 95% CI, 0.63\u20131.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our multicenter study indicated that care at a CCMC was associated with improved outcomes in patients with accidental hypothermia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.578","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T15:21:04Z","timestamp":1603812064000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Care at critical care medical centers is associated with improved outcomes in patients with accidental hypothermia: a historical cohort study from the J\u2010Point registry"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7150-0964","authenticated-orcid":false,"given":"Yoshihiro","family":"Fujimoto","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4068-0306","authenticated-orcid":false,"given":"Tasuku","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Morita","sequence":"additional","affiliation":[{"name":"Senri Critical Care Medical Center Saiseikai Senri Hospital Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Ehara","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Miyamae","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Rakuwa\u2010kai Otowa Hospital Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-476X","authenticated-orcid":false,"given":"Yohei","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Japanese Red Cross Society Kyoto Daini Red Cross Hospital Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Uji\u2010Tokushukai Medical Center Uji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1067-0609","authenticated-orcid":false,"given":"Yasuyuki","family":"Sumida","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine North Medical Center Kyoto Prefectural University of Medicine Yosa\u2010gun Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-2083","authenticated-orcid":false,"given":"Nobunaga","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Kyoto Prefectural University of Medicine Kyoto Japan"},{"name":"Department of Emergency and Critical Care Medicine National Hospital Organization, Kyoto Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine North Medical Center Kyoto Prefectural University of Medicine Yosa\u2010gun Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Nozawa","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital Ritto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumu","family":"Tsuruoka","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Kidney and Cardiovascular Center Kyoto Min\u2010iren Chuo Hospital Kyoto Japan"},{"name":"Emergency and Critical Care Medical Center Osaka City General Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Fukuchiyama City Hospital Fukuchiyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-0580","authenticated-orcid":false,"given":"Tetsuhisa","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Social and Environmental Medicine Division of Environmental Medicine and Population Sciences Graduate School of Medicine Osaka University Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Takegami","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2014.10.010"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Deaths attributed to heat, cold, and other weather events in the United States, 2006\u20132010","volume":"76","author":"Berko J","year":"2014","journal-title":"Natl Health Stat. Rep."},{"key":"e_1_2_8_4_1","first-page":"377","article-title":"The clinical characteristics of hypothermic patients in the winter of Japan \u2013 the final report of Hypothermia STUDY 2011","volume":"24","author":"Japanese Association for Acute Medicine","year":"2013","journal-title":"J. Jpn. Assoc. 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