Work

Patient and treatment characteristics that predict symptom resolution and limb amputation in patients with frostbite

Year: 2025

Type: article

Abstract: 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.

Source: Burns

DOI: 10.1016/j.burns.2025.107547