Authors (including presenting author) :
CHUANG KH, HO MS, IP KF, CHU SF, Candy HO, WONG MH
Affiliation :
Department of surgery, Princess Margaret Hospital
Introduction :
In Asian, it is estimated that the number of hip fracture will increase from around 1 million to 2.5 million in 2050. Elderly are at a high risk of hip fracture as bones tend to weaken with age. Therefore, Geriatric hip fracture places an increasing burden on health care service providers in Hong Kong.
Perioperative hypothermia is defined as core body temperature less than 36 degree celsius. It is one of the most common complications of geriatric patient undergoing hip surgery. Various adverse effects may arise when patient came across perioperative hypothermia. For example, increase bleeding tendency , surgical site infection etc. However, it is preventable.
Pre-warming is an effective and direct measures to prevent perioperative hypothermia. Pre-warming means warm patient’s skin and peripheral tissues before anesthesia
which can minimised the core heat loss from redistribution. A literature searched was conducted and conclude that at least 30 minutes of preoperative forced-air warming is the most effective method in preventing perioperative hypothermia.
However, due to the limited time and space available for prewarming procedures to be carried out in operation theatre, with the considerable benefits, why shouldn't we consider to carry out this preventive measures in ward setting? space / time for prewarming.
Objectives :
1. to improve the management of normothermia among geriatric hip fracture patients.
2. to reduce hypothermia rate after hip operation.
3. to improve patients' outcomes after hip surgery.
Methodology :
All eligible geriatric patients without fever received at least 30 minutes of preoperative forced-air warming in ward. The temperature setting of the warmer is 37.8 degree celsius. During the intervention, patients' temperature were monitored. Patients' data were recorded including details of the operation, temperature in different phase of the operation and patients’ outcomes like blood loss, length of stay etc.
Result & Outcome :
From May 2019 to Dec 2019, Total 75 patients were included. Patients’ age was between 66 to 95 years old. Results showed that only 5 % of patients undergone more than 30 minutes forced-air prewarming had experienced postoperative hypothermia, while before program 48% of patients had experienced postoperative hypothermia. After intervention, patients' length of stay reduced from 13 days to 11 days while surgical site infection rate also reduced from 2 % to 1.2%. Besides, the intervention also shows a positive effect in reducing blood loss during hip surgery.
