Temperatura corporal do paciente idoso no período pós­operatório / Body temperature of the elderly patient in the postoperative period / Temperatura corporal del paciente anciano en el período postoperatorio

Objetivo: Identificar a febre no idoso submetido à cirurgia ortopédica no período pós­operatório (PO). Método: Trata­se de um estudo de coorte histórica. Foram analisados 262 prontuários de idosos submetidos à cirurgia ortopédica, no período de janeiro de 2013 a dezembro de 2015. Foram incluídos os prontuários dos pacientes com idade maior ou igual a 60 anos, com registro completo da temperatura corporal entre o 1° e o 5° dia de pós­ope ratório (DPO). Resultados: Identificou­se que apenas 1% dos pacientes apresentou febre no período pós­operatório (38,7°C), sendo a maioria do sexo feminino (58%), com idade média de 74 anos; 52% foram submetidos à osteossíntese de terço proximal de fêmur, procedimento cirúrgico ortopédico que teve como maior causa a fratura de fêmur proximal (52%). Conclusão: Os resultados encontrados na pesquisa apontam para o cuidado necessário com o controle da temperatura após procedimentos cirúrgicos.

Objective: To identify fever in elderly patients submitted to orthopedic surgery during the postoperative period. Method: This is a retrospective cohort study. Two hundred and sixty-two medical records of elderly people submitted to orthopedic surgery in the period from January 2013 to December 2015 were analyzed. Medical records from 60-year-old patients or older, with complete registration of their body temperature between the first and fifth postoperative days, were included. Results: We found that only 1% of the patients had fever during the postoperative period (38.7°C), and most of them were female patients (58%), aged around 74 years; 52% underwent osteosynthesis of the proximal third of the femur ­ an orthopedic sur gical procedure that had as its main cause the proximal femur fracture (52%). Conclusion: The results found in the research indicate a necessary care, by means of which temperature is controlled after surgical procedures.

Objetivo: Identificar la fiebre en el anciano sometido a cirugía ortopédica en el período postoperatorio (PP). Método: Se trata de un estudio de cohorte histórica. Fueron analizados 262 prontuarios de ancianos sometidos a la cirugía ortopédica, en el período de enero de 2013 a diciembre de 2015. Fueron incluidos los prontuarios de los pacientes con edad mayor o igual a 60 años, con registro completo de la temperatura corporal entre el 1° y el 5° día de postoperatorio (DPO). Resultados: Se identificó que apenas el1% de los pacientes presentó fiebre en el período postoperatorio (38,7°C), siendo la mayoría del sexo femenino (58%), con edad promedio de 74 años; un 52% fue sometido a la osteosíntesis de terco proximal de fémur, procedimiento quirúrgico ortopédico que tuvo como mayor causa la fractura de fémur proximal (52%). Conclusión: Los resultados encontrados en el estudio apuntan para el cuidado necesario con el control de la temperatura tras procedimientos quirúrgicos.

Relationship Between Improvement on Antibacterials Use and Lowered Incidence of Drug-induced Hyperthermia / 医药导报

Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice,and elucidate the relationship between DIH incidence and antibacterials overuse.Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods,and data of DIH cases were extracted to perform a comparative study.The period for 229 effective cases of group Ⅰ was from Feb.1 to Apr.30,2011,before significant improvement on antibacterials use.The period for 342 effective cases of group Ⅱ was from Jul.1 to Sep.30,2012,after the effective enforcements of regulation on antibacterials use.Inclusion criteria for DIH were:①an oral temperature ≥37.6 ℃ since postoperative day 4,②no evidence of infection,③a time relationship between fever and the administration of causative drugs:a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature ≤ 37.6 ℃ until leaving hospital.Exclusion criteria for DIH were listed below:①possible pathological fever,e.g.,in cancer,②hospitalization within 3 days,③no surgery,④severe trauma,for example,visceral or central nervous system injury.Results All causative drugs were for injection.By comparison,duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7 ± 1.7 vs.4.6-± 1.8days,P ＜ 0.01),and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3％ vs.30.1％,1.5％ vs.25.3％,both P ＜0.01).Conclusion DIH incidence is related with drug type especially with antibacterials overuse,and changed with drug program.DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine.Decrease of antibacterials usage is positively associated with the decreased DIH incidence.Safe medication should begin from safe usage of antibacterials.