Burns : journal of the International Society for Burn Injuries · 2025
Patient and treatment characteristics that predict symptom resolution and limb amputation in patients with frostbite.
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Menon Vijay, Richards Lucas, Walter Carissa, Ackerman Peyton, Young Kate, Clark Lauren, Li Yanming, Alli Adam, Rohr Aaron
Аннотация
PURPOSE: To describe imaging and treatment received by frostbite patients and determine characteristics that predict symptom resolution and limb amputation.
MATERIALS AND METHODS: This retrospective study included 174 adult patients with acute frostbite at a single institution from May 1, 2004, to August 31, 2019. Demographics, frostbite classification, symptoms present and imaging received at presentation, treatment received, and dates of symptom resolution, were collected.
RESULTS: Patients most commonly received no imaging (60.3 %), followed by x-ray (28.7 %). The most common treatments were debridement (53.4 %), none (24.1 %), other (15.5 %), antibiotics (12.6 %), and tPA (8.0 %). Of 17 who had a limb amputated, the number of affected extremities (p = 0.003), frostbite degree (p = 0.004), and baseline symptoms of abnormal skin color change (p = 0.028), absence of pulse (p = 0.021), swelling (p = 0.010), and necrosis/gangrene (p = 0.002) significantly increased the risk of limb amputation. tPA lowered the risk of limb amputation with an estimated hazard ratio of 0.193 (p = 0.003).
DISCUSSION: Patients received a variety of treatments and imaging for frostbite. tPA was not often used in this study but could play a larger role in the treatment of frostbite since it was shown to lower the risk of limb amputation.
MATERIALS AND METHODS: This retrospective study included 174 adult patients with acute frostbite at a single institution from May 1, 2004, to August 31, 2019. Demographics, frostbite classification, symptoms present and imaging received at presentation, treatment received, and dates of symptom resolution, were collected.
RESULTS: Patients most commonly received no imaging (60.3 %), followed by x-ray (28.7 %). The most common treatments were debridement (53.4 %), none (24.1 %), other (15.5 %), antibiotics (12.6 %), and tPA (8.0 %). Of 17 who had a limb amputated, the number of affected extremities (p = 0.003), frostbite degree (p = 0.004), and baseline symptoms of abnormal skin color change (p = 0.028), absence of pulse (p = 0.021), swelling (p = 0.010), and necrosis/gangrene (p = 0.002) significantly increased the risk of limb amputation. tPA lowered the risk of limb amputation with an estimated hazard ratio of 0.193 (p = 0.003).
DISCUSSION: Patients received a variety of treatments and imaging for frostbite. tPA was not often used in this study but could play a larger role in the treatment of frostbite since it was shown to lower the risk of limb amputation.