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Deprivation in cold weather increases the risk of hospital admission with hypothermia in older people

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Abstract

Background

Material deprivation in cold weather may increase the risk of hypothermia and contribute to excess winter mortality. To date, there were no local data to support the potential contribution of material deprivation to the incidence of hypothermia in Irish older people.

Aim

To contribute evidence from a hospital-based perspective.

Methods

Patient series from St James’s Hospital Dublin, Ireland. Of all patients aged ≥65 years experiencing their last medical admission between 1 January 2002 and 31 December 2010, we selected those who presented with a body temperature of <35 °C. Their clinical characteristics were compared with those of a random sample of 200 age and gender-matched non-hypothermic patients. Multivariate logistic regression was used to identify predictors of presentation with hypothermia. The following predictors were considered: age, gender, mean air temperature on the day of admission, year of admission, comorbidity, major diagnostic categories, and material deprivation as per the Irish National Deprivation Index (NDI).

Results

Eighty patients presented with hypothermia over the period. They presented in colder days (mean 8.8 vs. 10.8 °C, P < 0.001) were less likely to present in summer (P < 0.002), more likely to present in winter (P = 0.010), and their mortality was high (50 vs. 17 %, P < 0.001). The interaction NDI* air temperature was a significant multivariate predictor of hypothermia (OR = 1.03, 95 % CI 1.01–1.06, P = 0.033).

Conclusions

The NDI could be an adequate tool to target fuel poverty in older people.

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Acknowledgments

We wish to recognise the contribution of our consultant medical colleagues and the non-consultant members of the on-call teams without whom we could not have progressed this initiative. Their continued enthusiasm for the practice of acute medicine in difficult circumstances within considerable resource constraints deserves recognition. We wish to thank the Harbour Master at Dún Laoghaire Harbour and Mr Glenn Dalgarno, Web master for the Dún Laoghaire Harbour Company (http://www.dlharbour.ie/).

Conflict of interest

None declared.

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Authors and Affiliations

  1. Division of Internal Medicine, St James’s Hospital, Dublin 8, Ireland

    R. Romero-Ortuno, M. Tempany, L. Dennis, D. O’Riordan & B. Silke

Authors
  1. R. Romero-Ortuno
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  2. M. Tempany
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  3. L. Dennis
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  4. D. O’Riordan
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  5. B. Silke
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Correspondence to R. Romero-Ortuno.

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Romero-Ortuno, R., Tempany, M., Dennis, L. et al. Deprivation in cold weather increases the risk of hospital admission with hypothermia in older people. Ir J Med Sci 182, 513–518 (2013). https://doi.org/10.1007/s11845-012-0896-4

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  • DOI: https://doi.org/10.1007/s11845-012-0896-4

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