[Study on accidental hypothermia in institutionalized elderly].

OBJECTIVE

To analyze the prevalence, causes and outcome of hypothermia in institutionalized elderly.

METHODS

Prospective study held from January to December, 2004 at the Hospital Geriátrico e de Convalescentes Dom Pedro II (Geriatric and Convalescent Hospital Dom Pedro II), with 483 long-term care beds. Hypothermia was diagnosed by esophageal thermometer in all patients with axillary temperature below or equal to 35 degrees C or 95 degrees F. Clinical examination and tests were used to obtain etiologic diagnosis and detect complications. Tests included: ECG, chest X-Ray, blood count, blood gas analysis, glycemia, biochemical blood tests, amylase, kidney and liver functions, urinalysis and serology for HIV, syphilis and hepatitis B. Rewarming was adopted, among other actions in the treatment protocol.

RESULTS

Thirty nine cases of hypothermia were confirmed, 31 in elderly (60 years old or over), 10 men and 21 women with an average age of 76.9 years. Eighty three percent of these patients had a high degree of dependence (Katz index between 'F' and 'G'). Seventy percent of these cases had mild hypothermia (32-35 degrees C [89.6-95 degrees F]), 25.0% had moderate hypothermia (28-31.9 degrees C [82.4-89.6 degrees F]) and 5.0% had severe hypothermia (<28 degrees C [<82.4 degrees F]). Seventy three percent of these patients died (50.0% during hypothermia and 50.0% after reversal). Infections were the etiology in all cases (Pneumonia [80.0%], urinary tract infection [60.0%] and pressure ulcer [17.1%]).

CONCLUSION

Hypothermia in institutionalized elderly is a serious clinical diagnosis with a high level of mortality. Prevention, early diagnosis and measures of central rewarming have collaborated for a better prognosis.