Hypothermia in the Japanese Elderly

• Published in: Nihon Rōnen Igakkai zasshi Vol. 22; no. 3; pp. 228 - 234
• Main Authors: Nakano, Tadasumi, Ito, Hideki, Inamatsu, Takashi, Murakami, Mototaka
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 1985
• Subjects: Aged; elderly; Humans; Hypothermia; Hypothermia - blood; Hypothermia - epidemiology; Hypothermia - mortality; Japan; Middle Aged; Triiodothyronine - blood; Japan
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.22.228

A study of hypothermia in Tokyo Metropolitan Geriatric Hospital during a 6 year period revealed that axillary temperature of 79 patients (0.51% of total admitted patients and 3.8% of total died cases) have been 35.0°C or less for at least 3 days. Distinct seasonal variation was found in the occurrence of hypothermia, most frequent in winter. Mean age of the hypothermic patients, 80.2 years old, was higher than that of all admitted, 73.3 years old, or died cases, 76.8 years old. Disturbed consciousness (80%), generalized edema (44%), hypotension (27%) and bradycardia (14%) were associated with hypothermia. High frequency of abnormal laboratory findings was recognized in the hypothermic patients, low hemoglobin levels (less than 9g/dl): 46%, low hematocrit levels (less than 30%): 60%, leukocytosis (more than 10000/mm3): 41%, thrombocytopenia (less than 100000/mm3): 61%, prolonged prothrombin time (more than 14 seconds): 79%, low fibrinogen levels (less than 200mg/dl): 68%, high fibrin/fibrinogen degradation products levels (more than 10μg/ml): 53%, hypoproteinemia (less than 5g/dl): 47%, high GOT levels (more than 20 IU): 65%, high GPT levels (more than 20 IU): 36%, high LDH levels (more than 110 IU): 48%, hypocholesterolemia (less than 100mg/dl): 39%, hypochloremia (less than 98mEq/l): 45%, hypocalcemia (less than 7.5mg/dl). 47%, high blood urea nitrogen levels (more than 30mg/dl): 69%, high serum creatinine levels (more than 1.5mg/dl): 41%, low serum triiodothyronine levels (less than 80ng/dl): 92%, acidemia (pH<7.35), and atrial fibrillation: 32%. In one patient, J wave was recorded on electrocardiogram. Predominant clinical settings of hypothermia were cerebrovascular accidents (43%), pneumonia (34%), hypoproteinemia (33%), malignancy (28%) and disseminated intravascular coagulation (22%). The average survival period of the hypothermic patients was 20 days and about a half of cases died within 10 days after the onset of hypothermia. The average survival period of the patients who did not recover from hypothermia was shorter than that of the patients who recovered. Serum total protein and total cholesterol levels in the former were significantly lower than those in the latter (p<0.01 and p<0.02, respectively). It was concluded that hypothermia was not infrequent in various morbid states commonly seen in the elderly and that the prognosis of hypothermia in the elderly was poor.