An evaluation of the Swiss staging model for hypothermia using case reports from the literature.BACKGROUND
 Core body temperature is used to stage and guide the management of hypothermic patients, however obtaining accurate measurements of core temperature is challenging, especially in the pre-hospital context.  The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia.  Medline was used to retrieve data on as many cases of accidental hypothermia (core body temperature <35 °C (95 °F)) as possible.  Cases of therapeutic or neonatal hypothermia and those with confounders or insufficient data were excluded.  To evaluate the Swiss staging model for hypothermia, we estimated the percentage of those patients who were correctly classified and compared the theoretical with the observed ranges of temperatures for each clinical stage.  Despite the inherent limitations of our study, it increases the strength of the evidence linking the clinical hypothermia stage to core temperature.  Decreasing the thresholds of temperatures distinguishing the different stages would allow a reduction in the number of cases where body temperature is overestimated, avoiding some potentially negative consequences for the management of hypothermic patients.
THERM