Abstract
The elderly, the very young, and the sick are known to be adversely affected by high environmental temperatures. In a retrospective open case-note review of 872 patients in a large institution during a hot summer we identified characteristics in the elderly that increase the risk of marginal hyperthermia. Women were more likely to be affected than men (25.6% vs 16.9%). We found an age-related increase in marginal hyperthermia, 15.7% of those below 60 years developed a hyperthermia compared to 18.9% in those between 70-79 years (non-significant), 28.3% in those between 80-89 years (p = 0.01) and 50% in those above 90 years (p < 0.01). There was also a direct relationship between the incidence of hyperthermia and the ambient temperature (29% in the warmer wards, compared to 17.2% in cooler ones; p < 0.01) and with the level of dependence (42.3% of the bedridden group, p < 0.01, and 20.4% of the semi-dependent, p < 0.01, compared to 11.1% of the mobile group). These factors were more significant as predictors of risk than the diagnosis. Identifying high risk patients early and taking appropriate measures to avoid hyperthermia and dehydration is important to try to decrease mortality during heatwaves.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bull G. M., Morton J. Environment, temperature and death rates. Age Ageing. 1978 Nov;7(4):210–224. doi: 10.1093/ageing/7.4.210. [DOI] [PubMed] [Google Scholar]
- Collins K. J., Exton-Smith A. N. 1983 Henderson Award Lecture. Thermal homeostasis in old age. J Am Geriatr Soc. 1983 Sep;31(9):519–524. [PubMed] [Google Scholar]
- Ellis F. P. Mortality from heat illness and heat-aggravated illness in the United States. Environ Res. 1972 Mar;5(1):1–58. doi: 10.1016/0013-9351(72)90019-9. [DOI] [PubMed] [Google Scholar]
- Godlee F. Health implications of climatic change. BMJ. 1991 Nov 16;303(6812):1254–1256. doi: 10.1136/bmj.303.6812.1254. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Katsouyanni K., Trichopoulos D., Zavitsanos X., Touloumi G. The 1987 Athens heatwave. Lancet. 1988 Sep 3;2(8610):573–573. doi: 10.1016/s0140-6736(88)92699-2. [DOI] [PubMed] [Google Scholar]
- Lye M., Kamal A. Effects of a heatwave on mortality-rates in elderly inpatients. Lancet. 1977 Mar 5;1(8010):529–531. doi: 10.1016/s0140-6736(77)91385-x. [DOI] [PubMed] [Google Scholar]
- Macey S. M., Schneider D. F. Deaths from excessive heat and excessive cold among the elderly. Gerontologist. 1993 Aug;33(4):497–500. doi: 10.1093/geront/33.4.497. [DOI] [PubMed] [Google Scholar]
- Oechsli F. W., Buechley R. W. Excess mortality associated with three Los Angeles September hot spells. Environ Res. 1970 Nov;3(4):277–284. doi: 10.1016/0013-9351(70)90021-6. [DOI] [PubMed] [Google Scholar]
- Robbins A. S. Hypothermia and heat stroke: protecting the elderly patient. Geriatrics. 1989 Jan;44(1):73-7, 80. [PubMed] [Google Scholar]
- Salvage A. V. Old people in hot weather. Age Ageing. 1991 Jul;20(4):233–235. doi: 10.1093/ageing/20.4.233. [DOI] [PubMed] [Google Scholar]