Mountain Rescue Activity and Limitations of Accidental Hypothermia Surveillance in Spain: A Descriptive Analysis of Guardia Civil Data, 2018–2021
Guillermo Muñoz, Guillem Serra, Jesús Ceballos
BACKGROUND: Accidental hypothermia is a potentially life-threatening complication of cold exposure in mountain and wilderness environments. Reliable surveillance requires clinically specific field data, but administrative rescue datasets may group hypothermia with other medical problems. OBJECTIVE: To describe mountain-rescue activity recorded by the Spanish Guardia Civil Mountain Service from 2018 through 2021 and assess whether publicly available administrative data can support estimation of accidental-hypothermia prevalence, severity, or clinical impact. METHODS: We performed a retrospective descriptive secondary analysis of aggregate data from the Statistical Yearbooks of the Spanish Ministry of the Interior. Annual intervention totals were extracted for 2018–2021. Detailed 2021 data were summarized using separate denominators for rescue interventions and rescued persons, including activity, accident type, mountain massif, age, sex, and rescue status. Because the public data contain no hypothermia-specific count, core-temperature field, clinical stage, treatment data, or patient-level linkage, no hypothermia prevalence estimate or causal analysis was attempted. RESULTS: Across 2018–2021, 3,780 mountain-rescue interventions were recorded: 974 in 2018, 981 in 2019, 790 in 2020, and 1,035 in 2021. Interventions decreased by 19.5% from 2019 to 2020 and increased by 31.0% from 2020 to 2021. In 2021, 1,489 rescued persons were reported across 1,035 interventions; 102 were recorded as deceased, 654 as injured, and 733 as uninjured at rescue reporting. Men represented 62.9% of rescued persons, and the largest age group was 19–30 years (22.4%). Hiking accounted for 552/1,035 interventions (53.3%), the Aragonese Pyrenees for 402/1,035 (38.8%), and same-level trips/falls for 302/1,035 (29.2%). A broad “physical problems” category accounted for 127/1,035 interventions (12.3%) and included severe hypothermia together with other medical conditions; hypothermia-specific frequency could not be isolated. CONCLUSION: Guardia Civil data provide a useful description of mountain-rescue workload but do not support estimation of accidental-hypothermia prevalence, severity, or outcome. Future surveillance should separately record suspected or confirmed hypothermia, core temperature and measurement method, clinical severity, exposure context, treatment, and outcome using harmonized definitions across rescue services.