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. 2018 May 7;15(2):624-629.
doi: 10.1016/j.jor.2018.05.020. eCollection 2018 Jun.

What is the incidence of inadvertent hypothermia in elderly hip fracture patients and is this associated with increased readmissions and mortality?

M Williams  1 , M Ng  1 , M Ashworth  1
Affiliations

What is the incidence of inadvertent hypothermia in elderly hip fracture patients and is this associated with increased readmissions and mortality?

M Williams et al. J Orthop. .

Abstract

Background: Globally the incidence of fragility hip fractures is rising with increasingly elderly and co-morbid patients. These injuries are associated with a high morbidity and mortality.

Aims: This clinical study's primary outcome is to establish the rate of operative inadvertent hypothermia (<36 °C) in elderly hip fracture patients (>65 years old). We also aimed to identify risk factors and outcomes in patients with inadvertent hypothermia.

Patients and methods: A single centre, retrospective study of 929 hip fracture patients managed operatively between June 2015 and July 2017 was conducted. Patients' demographic, anaesthetic and surgical variables were analysed together with outcomes for length of stay (LoS), 30-day re-admissions, and 30-day mortality.

Results: Overall rates of inadvertent hypothermia in elderly hip fracture patients undergoing surgery were 10%, with increasing age (p = 0.006) and pre-operative hypothermia (p < 0.0001) as risk factors. Patient's hypothermic pre-operatively compared with normothermic patients were 1.9 times more likely to be <36 °C on leaving theatre. There was a trend towards a higher 30-day mortality (χ2(1) = 2.818, p = 0.093), and a significantly higher mortality in patients undergoing SHS (p = 0.03). No survival differences for LoS were observed between hypothermic and ≥36 °C patients (χ2(1) = 0.069, p = 0.79). 30-day re-admissions were higher in hypothermic patients (χ2(1) = 16.301, p < 0.0001).

Conclusion: Rates of inadvertent hypothermia are high in operatively managed hip fracture patients and are significantly associated with a higher 30-day readmission rate with a trend towards higher 30-day mortality.

Keywords: Hip fracture; Hypothermia; Inadvertent hypothermia; Mortality; Neck of femur fracture; Readmissions.

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Figures

Fig. 1
Fig. 1
Flowchart of patients who underwent surgery for hip fracture included in the study.
Chart 1
Chart 1
Kaplan-Meier survival chart demonstrating length of stay of patients following hip fracture surgery with two cohorts: inadvertent hypothermic and normothermic groups. A log rank test the 2 groups were not statistically significantly different, χ2(1) = 0.069, p = 0.79.
See this image and copyright information in PMC

References

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