Elderly at risk of hypothermia at home
Elderly Australians are dying in hospital of hypothermia developed living in their own homes, a study by The Alfred's Dr Michelle Ananda-Rajah has found.
The study, conducted across The Alfred and Sandringham emergency departments (ED), found 217 people presented to ED with hypothermia between 2009 and 2016. Of those, 11 per cent died.
Nearly 80 per cent of the patients were found indoors and were more likely to be elderly with several health conditions.
Dr Ananda-Rajah, a general medicine physician at The Alfred, said an influx of people suffering hypothermia during the winter of 2015 – the coldest experienced in Victoria in 26 years – alerted doctors to the problem.
“There was a real run of these patients which made us interested in seeing any patterns of the hypothermia presentations,” Dr Ananda-Rajah said.
The researchers analysed retrospective data from patients with body temperatures lower than 35°c from The Alfred and Sandringham hospital emergency departments for the study.
“Questions must be asked as to why these people are developing this condition, particularly the elderly who are indoors,” Dr Ananda-Rajah said.
“The elderly seem to be particularly vulnerable. Do they have adequate heating and homes that are well-insulated? Are they wearing adequate clothing? Are they able to afford heating?”
The research paper, published in Internal Medicine Journal, raises the issue of fuel poverty, topical given rising energy bills.
However, factors other than just the winter cold were involved, Dr Ananda-Rajah said. The majority of cases (72 per cent) occurred during the colder months (late autumn to early spring) but notably 12 per cent occurred during summer.
Certain medications as well as older age can affect the ability of the body to raise its own temperature. Elderly patients who had heart failure, cancer, chronic kidney disease and sepsis infection were especially likely to die in hospital.
“We found that 27 per cent of patients coming in with hypothermia had an infection brewing. In a significant number of these patients it probably wasn’t appreciated that they had what’s called “cold” sepsis rather than sepsis associated with a fever as infection usually appears," she said.
“Doctors and clinicians should really think about infection as a cause of hypothermia and manage it appropriately.”
For more, access the full research paper.
