Gurunathan Usha, Stonell Christopher, Fulbrook Paul
The Prince Charles Hospital, Brisbane, Australia.
University of Queensland, Brisbane, Australia.
J Eval Clin Pract. 2017 Aug;23(4):762-766. doi: 10.1111/jep.12712. Epub 2017 Feb 16.
Elderly patients are at high risk of accidental perioperative hypothermia. The primary objective of this study was to measure the changes in body temperature and the incidence of hypothermia in elderly patients undergoing hip fracture surgery.
We conducted a prospective observational study on all adult patients undergoing surgery for fractured neck of femur between December 2013 and July 2014. We monitored their temperatures in different perioperative areas at multiple time points and also noted the warming methods used.
Eighty-seven patients were included in this study. A significant drop in body temperature (0.7°C, 95% CI: 0.6-0.9, P < 0.001) occurred from their arrival at the operating theatre until their arrival at the recovery room. A significant drop of 0.2°C (95% CI: 0.1-0.4, P < 0.001) was observed at the holding bay area. One third of the patients were noted to be hypothermic when they arrived at the recovery room.
These results indicate that despite the use of active warming methods for most patients, significant hypothermia is still an issue amongst elderly patients undergoing hip fracture surgery. Further improvement is necessary to prevent hypothermia in this high-risk group of patients.
老年患者围手术期意外体温过低风险较高。本研究的主要目的是测量接受髋部骨折手术的老年患者体温变化及体温过低的发生率。
我们对2013年12月至2014年7月期间所有接受股骨颈骨折手术的成年患者进行了一项前瞻性观察研究。我们在围手术期不同区域的多个时间点监测他们的体温，并记录所采用的保暖方法。
本研究纳入了87例患者。从他们抵达手术室到抵达恢复室，体温显著下降（0.7°C，95%置信区间：0.6 - 0.9，P < 0.001）。在等候区观察到体温显著下降0.2°C（95%置信区间：0.1 - 0.4，P < 0.001）。三分之一的患者在抵达恢复室时被发现体温过低。
这些结果表明，尽管大多数患者采用了主动保暖方法，但体温显著过低仍是接受髋部骨折手术的老年患者中的一个问题。有必要进一步改进以预防这一高危患者群体的体温过低情况。
