{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T21:44:12Z","timestamp":1783028652958,"version":"3.54.6"},"reference-count":28,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Research in accidental hypothermia focuses on trauma patients, patients exposed to cold environments or patients after drowning but rarely on hypothermia in combination with intoxications or on medical or neurological issues. The aim of this retrospective single-centre cohort study was to define the aetiologies, severity and relative incidences of accidental hypothermia, methods of measuring temperature and in-hospital mortality. Methods: The study included patients \u226518 years with a documented body temperature \u226435 \u00b0C who were admitted to the emergency department (ED) of the University Hospital in Bern between 2000 and 2019. Results: 439 cases were included, corresponding to 0.32 per 1000 ED visits. Median age was 55 years (IQR 39\u201370). A total of 167 patients (38.0%) were female. Furthermore, 63.3% of the patients suffered from mild, 24.8% from moderate and 11.9% from severe hypothermia. Exposure as a single cause for accidental hypothermia accounted for 12 cases. The majority were combinations of hypothermia with trauma (32.6%), medical conditions (34.2%), neurological conditions (5.2%), intoxications (20.3%) or drowning (12.0%). Overall mortality was 22.3% and depended on the underlying causes, severity of hypothermia, age and sex.<\/jats:p>","DOI":"10.3390\/ijerph191710735","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T21:01:31Z","timestamp":1661806891000},"page":"10735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Accidental Hypothermia in a Swiss Alpine Trauma Centre\u2014Not an Alpine Problem"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-4526","authenticated-orcid":false,"given":"Katrin","family":"Habegger","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Brechb\u00fchler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Vogt","sequence":"additional","affiliation":[{"name":"H\u00f4pital du Valais, Spitalzentrum Oberwallis, 3930 Visp, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin S.","family":"Lienert","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Fribourg Hospital, 1752 Villars-sur-Gl\u00e2ne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca M.","family":"Engelhardt","sequence":"additional","affiliation":[{"name":"Swiss Army, Military Medical Service, Regional Military Medical Center of Thun, 3600 Thun, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4067-7174","authenticated-orcid":false,"given":"Martin","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristomenis K.","family":"Exadaktylos","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5608-7887","authenticated-orcid":false,"given":"Monika","family":"Brodmann Maeder","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"},{"name":"EURAC Research, Institute of Mountain Emergency Medicine, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1056\/NEJMra1114208","article-title":"Accidental hypothermia","volume":"367","author":"Brown","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s13049-016-0303-7","article-title":"Accidental hypothermia\u2013an update","volume":"24","author":"Paal","year":"2016","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1503\/cmaj.081327","article-title":"Patterns of death among avalanche fatalities: A 21-year review","volume":"180","author":"Boyd","year":"2009","journal-title":"CMAJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.resuscitation.2016.06.001","article-title":"Burial duration, depth and air pocket explain avalanche survival patterns in Austria and Switzerland","volume":"105","author":"Procter","year":"2016","journal-title":"Resuscitation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1757-7241-22-6","article-title":"Accidental cold-related injury leading to hospitalization in northern Sweden: An eight-year retrospective analysis","volume":"22","author":"Johansson","year":"2014","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/j.injury.2014.07.001","article-title":"Epidemiology and mortality of glacier crevasse accidents","volume":"45","author":"Pasquier","year":"2014","journal-title":"Injury"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.resuscitation.2021.08.016","article-title":"Hypothermic Cardiac Arrest\u2013Retrospective cohort study from the International Hypothermia Registry","volume":"167","author":"Walpoth","year":"2021","journal-title":"Resuscitation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13049-014-0086-7","article-title":"Accidental hypothermia in Poland\u2013estimation of prevalence, diagnostic methods and treatment","volume":"23","author":"Darocha","year":"2015","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_9","first-page":"85","article-title":"The trauma triad of death: Hypothermia, acidosis, and coagulopathy","volume":"10","author":"Mikhail","year":"1999","journal-title":"AACN Adv. Crit. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0020-1383(03)00309-7","article-title":"Hypothermia in the trauma patient","volume":"35","author":"Tsuei","year":"2004","journal-title":"Injury"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.injury.2011.10.013","article-title":"Effects of accidental hypothermia on posttraumatic complications and outcome in multiple trauma patients","volume":"44","author":"Mommsen","year":"2013","journal-title":"Injury"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1097\/TA.0000000000001220","article-title":"Epidemiology of accidental hypothermia in polytrauma patients: An analysis of 15,230 patients of the TraumaRegister DGU","volume":"81","author":"Weuster","year":"2016","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/01.shk.0000169726.25189.b1","article-title":"Injury-Associated Hypothermia: An Analysis of the 2004 National Trauma Data Bank","volume":"24","author":"Martin","year":"2005","journal-title":"Shock"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4106","DOI":"10.1007\/s00268-020-05750-5","article-title":"The impact of accidental hypothermia on mortality in trauma patients overall and patients with traumatic brain injury specifically: A systematic review and meta-analysis","volume":"44","author":"Candinas","year":"2020","journal-title":"World J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/j.resuscitation.2010.05.023","article-title":"Accidental hypothermia: Rewarming treatments, complications and outcomes from one university medical centre","volume":"81","author":"Goslings","year":"2010","journal-title":"Resuscitation"},{"key":"#cr-split#-ref_16.1","unstructured":"Habegger, K. (2013). Akzidentelle Hypothermie an einem Zentrumsspital"},{"key":"#cr-split#-ref_16.2","unstructured":"Datenaufarbeitung vom 1 January 2000-31 March 2012. [Master's Thesis, University of Bern]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ijcard.2012.01.020","article-title":"Use of minimal extracorporeal circulation improves outcome after heart surgery; a systematic review and meta-analysis of randomized controlled trials","volume":"164","author":"Anastasiadis","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.injury.2010.11.037","article-title":"The Bernese Hypothermia Algorithm: A consensus paper on in-hospital decision-making and treatment of patients in hypothermic cardiac arrest at an alpine level 1 trauma centre","volume":"42","author":"Maeder","year":"2011","journal-title":"Injury"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1136\/emermed-2017-207238","article-title":"Characteristics and outcomes of accidental hypothermia in Japan: The J-Point registry","volume":"35","author":"Matsuyama","year":"2018","journal-title":"Emerg. Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1111\/ggi.13502","article-title":"Prevalence and outcomes of accidental hypothermia among elderly patients in Japan: Data from the J-Point registry","volume":"18","author":"Morita","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e046806","DOI":"10.1136\/bmjopen-2020-046806","article-title":"Accidental hypothermia in Denmark: A nationwide cohort study of incidence and outcomes","volume":"11","author":"Wiberg","year":"2021","journal-title":"BMJ Open"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Paal, P., Pasquier, M., Darocha, T., Lechner, R., Kosinski, S., Wallner, B., Zafren, K., and Brugger, H. (2022). Accidental hypothermia: 2021 update. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010501"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1136\/emermed-2018-207804","article-title":"Indoor accidental hypothermia in the elderly: An emerging lethal entity in the 21st century","volume":"35","author":"Paal","year":"2018","journal-title":"Emerg. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1038\/nrn3174","article-title":"Neuroprotective mechanisms of hypothermia in brain ischaemia","volume":"13","author":"Yenari","year":"2012","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.resuscitation.2018.02.026","article-title":"Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score","volume":"126","author":"Pasquier","year":"2018","journal-title":"Resuscitation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.resuscitation.2019.03.017","article-title":"Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: An external validation of the HOPE score","volume":"139","author":"Pasquier","year":"2019","journal-title":"Resuscitation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ajem.2018.06.025","article-title":"Prognostic factors for patients with accidental hypothermia: A multi-institutional retrospective cohort study","volume":"37","author":"Okada","year":"2019","journal-title":"Am. J. Emerg. Med."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/17\/10735\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:19:23Z","timestamp":1760141963000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/17\/10735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,29]]},"references-count":28,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijerph191710735"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191710735","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,29]]}}}