Case series of non-freezing cold injury: epidemiology and risk factors
Case series of non-freezing cold injury: epidemiology and risk factors
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DOI：
10.1136/jramc-2018-000992
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发表时间：
2019-12-01
影响因子：
--
通讯作者：
Hollis, S.
中科院分区：
文献类型：
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作者：
Kuht, James A.;Woods, D.;Hollis, S.
背景非冻结性冷损伤(NFCI)发生在周围组织充分降温到损伤发生时，但不会达到组织冻结的程度。从历史上看，所研究的损伤的表型通常是严重的，目前尚不清楚从这些病例中获得的知识是否与今天经常看到的轻微损伤完全相关。方法因此，我们试图描述最近转诊到英国一家军事NFCI诊所的100名疑似NFCI患者的特征。对致伤的人口学特征、病史和环境危险因素进行分析，并对76例NFCI患者和24例候诊患者进行比较。结果在英国服役人员(SP)中，有统计学意义的NFCI的易感因素是非洲加勒比民族和在武装部队服役时间较短。过去或现在吸烟不被确定为危险因素。几乎总是在训练练习中受伤(在英国最常见)；普遍寒冷和执行静态任务是统计上显著的情景风险因素。穿湿衣服、湿靴子和浸泡在水中的风险趋势也不明显。自我报告的脱水并不是NFCI的危险因素。结论我们的人口学研究结果与以前的研究结果基本一致。然而，我们的情景风险因素发现突出了NFCI风险因素对现代英国SP的一个模式：冬季训练演习，当时部队通常很冷，四肢经常湿透，静态任务经常与疾病机制有关。
Background Non-freezing cold injury (NFCI) occurs when the peripheral tissue is cooled sufficiently that damage occurs, but not to the point of tissue freezing. Historically, the phenotype of the injuries studied was often severe, and it is unclear whether knowledge gained from these cases is entirely relevant to the frequently subtle injuries seen today. Methods We therefore sought to characterise a recent case series of 100 patients referred with suspected NFCI to a military UK NFCI clinic. Their demographics, medical history and situational risk factors leading to their injuries were analysed, and comparison was made between those subsequently diagnosed with NFCI (n=76) and those receiving alternate diagnoses (n=24). Results Statistically significant predisposing factors for NFCI in the UK service personnel (SP) were being of African-Caribbean ethnicity and having a short duration of service in the Armed Forces. Past or current smoking was not identified as a risk factor. Injuries were almost always suffered on training exercises (most commonly in the UK); being generally cold and being on static duties were statistically significant situational risk factors. Non-significant trends of risk were also found for having wet clothing, wet boots and immersion. Self-reported dehydration was not found to be a risk factor for NFCI. Conclusions Our demographic findings are in general agreement with those of previous studies. Our situational risk factor findings, however, highlight a pattern of NFCI risk factors to the modern UK SP: winter training exercises, when troops are generally cold and extremities often wet, with static duties frequently implicated in the disease mechanism.