Frostbite largely impacts the extremities and often results in long term disability due to amputation. More regions are experiencing extremes in temperature which increases risk of frostbite injury. The aim of this study is to detail social and comorbid factors associated with frostbite injury compared to isolated hand or foot burns. We used the National Inpatient Sample from years 2016 to 2018 to identify admissions included in this study. Weighted incidence and multivariable analysis assessed characteristics and outcomes of frostbite and isolated hand or foot burn injury. In the United States, the estimated incidence of frostbite injury in those aged 15 and over was 0.95 per 100,000 persons and 4.44 per 100,000 persons with isolated hand and foot burns. Homelessness, mental health disorder, drug or alcohol abuse, and peripheral vascular disease were all associated with risk of frostbite injury when compared to burn injury. We found that other insurance was associated with amputation following burn injury, while Black race and homelessness were associated with amputation during a non-elective primary admission following frostbite injury. The differing risk factors associated with early amputation in frostbite and burn patients warrant a multicenter study including burn centers in North America.
