Analysis of Treatment Outcomes in Patients with Cold Injuries

Alexander F. Potapov, Albina A. Ivanova, Svetlana V. Semenova, Semen D. Nusugurov

International Journal of Biomedicine. 2020;10(3):274-277.
DOI: 10.21103/Article10(3)_OA15
Originally published September 10, 2020


Background: The aim of this research was to study the prevalence rate, structure, treatment methods and outcomes for patients with severe frostbite and hypothermia admitted to the Intensive Care Unit (ICU) for patients with thermal injuries.
Methods and Results: We performed a retrospective analysis of the treatment outcomes for 108 patients (83/76.9% men and 25/23.1% women) exposed to excessive natural cold  and treated in ICU-1 of Republican Hospital #2 - Center for Emergency Medical Aid in the city of Yakutsk in the period 2017-2019. The age of the adult patients ranged from 18 to 77 years (mean age of 47.5±14.9 years), and three children were 2, 4, and 17 years of age. The diagnosis of hypothermia was made by measuring the core (rectal) temperature (trect). The following gradation scale was applied: mild (trec 32°C-35°C), moderate (trec 28°C-32°C), and severe (trect <28°C) hypothermia.
The comprehensive treatment of frostbite was carried out in accordance with modern clinical guidelines. Among all patients with cold injuries, 38(35.2%) patients with combined hypothermia constituted the most severe category: mild hypothermia was observed in 26(68.4%), moderate in 7(18.4%), and severe in 5(13.2%) patients. Due to the development of tissue necrosis and its non-viability, various surgeries were performed on 33(30.5%) patients with third- and fourth-degree frostbite, including amputations of various limb segments in 29(87.9%) patients. The treatment duration for all the ICU patients with cold injury was 4.2±2.1 bed/days, and for the patients with combined hypothermia – 7.9±4.4 bed/days. Over the study period, 3(2.7%) patients with cold injury died.
Conclusion: The presented data show the relevance of the cold injury issue in the region, with severe frostbite with tissue necrosis resulting in amputation of extremities at different levels in 30.5% of the patients. Moreover, in 35.2% of the cases, frostbite was combined with hypothermia, which made the treatment even more difficult.

excessive natural cold • hypothermia • frostbite • Far North
  1. Diagnosis and Treatment of Frostbite (Clinical Guidelines, 2017).
  2. State of Alaska: Cold Injuries Guidelines 2014.
  3. European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. First aid.
  4. Monika BM, Martin D, Balthasar E, et al. 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. Injury. 2011;42(5):539‐543. doi:10.1016/j.injury.2010.11.037
  5. Order of the Ministry of Health of the Russian Federation No. 174 dated May 17,  1999 “On the measures on further improvements in tetanus prophylaxis”.
  6. Ivanova A., Potapov A., Alekseev R., Semenova S. Cold injury as a cause of disability and mortality of population in the region of the High North. NJDIS 2017; 5(1): 66-70.
  7. Ivanova AA, Potapov AF, Bosikov DV, Bulatov AV, Makarova TS. External causes in the structure of premature mortality in the Republic of Sakha (Yakutia). International Journal of Biomedicine. 2019; 9(1):75-79.

Download Article
Received May 15, 2020.
Accepted June 9, 2020.
©2020 International Medical Research and Development Corporation.