#49 Pediatric frostbite: a 10-year single-center retrospective study
Chris M Nguyen, Manitoba Firefighter’s Burn Unit, University of Manitoba; Ramy Boles, University of Toronto; Justin Gawaziuk, Health Sciences Centre; Nora Cristall, Max Rady College of Medicine; Sarvesh Logsetty, University of Manitoba
Frostbite is a thermal injury from frozen tissue. Literature is limited on children, a vulnerable population not in control of their environment. The objective is to describe frostbite in children referred to a regional pediatric hospital and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to injury.
Retrospective chart review of 47 patients < 18 years old examining demographics, and intrinsic and extrinsic factors related to injuries. Injury characteristics assessed included illicit drug use, injury circumstance, ambient temperature at the time of injury, exposure duration, and factors related to injury including intoxication and supervision. Summary statistics are presented as median (IQR) or number (%). Kolmogorov-Smirnov test was used to determine normality. Mann-Whitney U test compared differences in median ambient temperature or median exposure duration between subgroupings.
Median age was 15 years (IQR 12-16) and 49% were admitted. Frequently documented risk activities included the use of alcohol (53%), cigarettes (34%), marijuana (23%), and depression and/or suicidality symptoms (32%). Although frostbite starts to present at < -6°C, procedures were only required for frostbite occurring at temperatures < -23°C (p =.001). Along with colder ambient temperature, long exposure duration (p <.001) was significantly related to the likelihood of procedure, as opposed to conservative management. Two factors related to injury were identified: intoxication and lack of supervision. Among patients 0-12 years, lack of supervision at the time of injury was common (64%), while intoxication among older patients ages 13-17 was common (61%).
To our knowledge, this is the largest retrospective study of pediatric frostbite. These findings call for targeted outreach to reduce frostbite incidence. For younger children, the focus must be on involving and educating parents on risks of unsupervised care. For older children, informing youth on risks of frostbite alongside approaches to curb adolescent alcohol use are warranted.