Cardiac arrest secondary to environmental hypothermia: Incidence and outcomes in an urban emergency department in the Upper Midwestern United States

Data describing hypothermic cardiac arrest (HCA) outcomes predominantly originate from patients involved in wilderness accidents. We describe the incidence and outcomes of HCA in an urban environment, with a subgroup analysis of patients with witnessed HCA in the prehospital or emergency department (ED) setting. We completed a retrospective, single center cohort analysis of consecutive adult patients with environmental exposure and core body temperature ≤ 32 °C. We describe characteristics of this cohort and evaluate the relationship between initial core temperature and occurrence of HCA. 171 patients met eligibility criteria from January 2007 to September 2023. 43 (25 %) sustained HCA, including 6/98 (6 %) of those with moderate hypothermia (28.01–32 °C), 21/55 (38 %) with severe hypothermia (24–28 °C) and 16/18 (89 %) with profound hypothermia (