Temperatura basal em idosos asilados

Gorzoni, Milton Luiz; Pires, Sueli Luciano; Faria, Lílian de Fátima Costa

doi:10.1590/S1809-98232010000200002

Resumos

INTRODUÇÃO: Idosos tendem a apresentar temperaturas corporais menores do que adultos jovens. A determinação da temperatura basal em populações de instituições de longa permanência para idosos (ILPIs) auxiliará em novas definições sobre estados febris nessa faixa etária e nesses locais, evitando diagnósticos tardios ou equivocados. OBJETIVO: Determinar valores de temperatura basal axilar em internados clinicamente estáveis em instituição de longa permanência para idosos (ILPI). CASUÍSTICA E MÉTODO: Avaliaram-se, em agosto de 2005, idosos (idade > 60 anos) de ambos os sexos, com grau de dependência intermediária (perda de duas dentre seis atividades básicas da vida diária) e residentes em ILPI. Utilizaram-se média e desvio padrão de três temperaturas axilares matinais, obtidas por meio de termômetro clínico prismático IncotermÒ. O mês de agosto de 2005 apresentou, na região da ILPI deste estudo, temperaturas ambientais médias entre 14ºC e 26ºC. RESULTADOS: Obtiveram-se dados de 47 idosos (16 mulheres, 31 homens) com média etária de 72,8 ± 10,6 anos. Temperatura axilar média matinal: 36,1º ± 0,2ºC, sendo de 36,1º ± 0,2ºC nas mulheres e de 36,2º ± 0,2ºC nos homens. Não houve significância estatística quanto ao sexo ou faixa etária e temperaturas aferidas. CONCLUSÃO: Idosos institucionalizados apresentam temperatura axilar média matinal e/ou basal inferior à normal em adultos jovens. Este fato merece atenção pelo risco do desenvolvimento de síndromes com temperaturas atípicas como, por exemplo, quadros infecciosos afebris e hipotermias.

Temperatura Corporal; Idoso; Instituição de Longa Permanência para Idosos

INTRODUCTION: The elderly tend to present lower body temperatures than younger adults. Determining the basal body temperature in long term institutionalized elderly populations will help find new definitions of febrile state for that age group and location, thus avoiding late or wrong diagnosis. OBJECTIVE: Determine the axillary basal body temperature values in clinically stable elderly living in long term care (LTC) institutions. METHOD: In August 2005 institutionalized elderly from both genders (age > 60 years), with intermediate dependence level (loss of two out of six basic daily activities) were evaluated. The average and standard deviation for three morning axillary temperatures was obtained through IncotermÒ prismatic clinical thermometer measurements. In the LTC institution area for the study herein August 2005 has presented average environmental temperatures between 14ºC and 26ºC. RESULTS: 47 elderly patients were studied (16 women, 31 men) with an average age of 72.8 ± 10.6 years. Morning average axillary temperature: 36.1º ± 0.2ºC, with 36.1º ± 0.2ºC for women and 36.2º ± 0.2ºC for men. There was no statistical significance related to gender or age and temperatures measured. CONCLUSION: Institutionalized elderly presented an average or basal morning axillary temperature lower than normal in young adults. That fact deserves attention due to the risk of developing syndromes with atypical temperatures, such as non-febrile infectious profiles and hypothermias.

Aged; Body Temperature; Homes for the Aged

ARTIGOS ORIGINAIS ORIGINAL ARTICLES

Temperatura basal em idosos asilados

Basal body temperature in institutionalized elderly

Milton Luiz Gorzoni^I; Sueli Luciano Pires^II; Lílian de Fátima Costa Faria^III

^IDepartamento de Clínica Médica, Disciplina de Gerontologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo Brasil (FCMSCSP). São Paulo, SP, Brasil

^IIFaculdade de Ciências Médicas da Santa Casa de São Paulo e Hospital Geriátrico e de Convalescentes Dom Pedro II (HGCDPII) da Irmandade da Santa Casa de Misericórdia de São Paulo. São Paulo, SP, Brasil

^IIIUnidade de Agudos do Hospital Geriátrico e de Convalescentes Dom Pedro II (HGCDPII) da Irmandade da Santa Casa de Misericórdia de São Paulo. São Paulo, SP, Brasil

RESUMO

INTRODUÇÃO: Idosos tendem a apresentar temperaturas corporais menores do que adultos jovens. A determinação da temperatura basal em populações de instituições de longa permanência para idosos (ILPIs) auxiliará em novas definições sobre estados febris nessa faixa etária e nesses locais, evitando diagnósticos tardios ou equivocados.

OBJETIVO: Determinar valores de temperatura basal axilar em internados clinicamente estáveis em instituição de longa permanência para idosos (ILPI).

CASUÍSTICA E MÉTODO: Avaliaram-se, em agosto de 2005, idosos (idade > 60 anos) de ambos os sexos, com grau de dependência intermediária (perda de duas dentre seis atividades básicas da vida diária) e residentes em ILPI. Utilizaram-se média e desvio padrão de três temperaturas axilares matinais, obtidas por meio de termômetro clínico prismático IncotermÒ. O mês de agosto de 2005 apresentou, na região da ILPI deste estudo, temperaturas ambientais médias entre 14ºC e 26ºC.

RESULTADOS: Obtiveram-se dados de 47 idosos (16 mulheres, 31 homens) com média etária de 72,8 ± 10,6 anos. Temperatura axilar média matinal: 36,1º ± 0,2ºC, sendo de 36,1º ± 0,2ºC nas mulheres e de 36,2º ± 0,2ºC nos homens. Não houve significância estatística quanto ao sexo ou faixa etária e temperaturas aferidas.

CONCLUSÃO: Idosos institucionalizados apresentam temperatura axilar média matinal e/ou basal inferior à normal em adultos jovens. Este fato merece atenção pelo risco do desenvolvimento de síndromes com temperaturas atípicas como, por exemplo, quadros infecciosos afebris e hipotermias.

Palavras-chave: Temperatura Corporal. Idoso. Instituição de Longa Permanência para Idosos.

ABSTRACT

INTRODUCTION: The elderly tend to present lower body temperatures than younger adults. Determining the basal body temperature in long term institutionalized elderly populations will help find new definitions of febrile state for that age group and location, thus avoiding late or wrong diagnosis.

OBJECTIVE: Determine the axillary basal body temperature values in clinically stable elderly living in long term care (LTC) institutions.

METHOD: In August 2005 institutionalized elderly from both genders (age > 60 years), with intermediate dependence level (loss of two out of six basic daily activities) were evaluated. The average and standard deviation for three morning axillary temperatures was obtained through IncotermÒ prismatic clinical thermometer measurements. In the LTC institution area for the study herein August 2005 has presented average environmental temperatures between 14ºC and 26ºC.

RESULTS: 47 elderly patients were studied (16 women, 31 men) with an average age of 72.8 ± 10.6 years. Morning average axillary temperature: 36.1º ± 0.2ºC, with 36.1º ± 0.2ºC for women and 36.2º ± 0.2ºC for men. There was no statistical significance related to gender or age and temperatures measured.

CONCLUSION: Institutionalized elderly presented an average or basal morning axillary temperature lower than normal in young adults. That fact deserves attention due to the risk of developing syndromes with atypical temperatures, such as non-febrile infectious profiles and hypothermias.

Key words: Aged. Body Temperature. Homes for the Aged.

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AGRADECIMENTO

Agradecemos ao Núcleo de Apoio à Publicação da Faculdade de Ciências Médicas da Santa Casa de São Paulo NAP-SC, pelo suporte técnico-científico à publicação deste manuscrito.

REFERÊNCIAS

1. Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992 sep; 268(12): 1578-80.

2. Pearce JM. A brief history of the clinical thermometer. QJM. 2002 Apr; 95(4): 251-2.

3. Sund-Levander M, Forsberg C, Wahren LK. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand J Caring Sci 2002 jun; 16(2): 122-8.

4. Katz S, et al. Progress in development in the index of ADL. Gerontologist 1970 apr; 10(1): 20-30.

5. Mallari B. Temperature. University of Illinois Medical Center: Health Library. disponível em URL: http://uimc.discoveryhospital.com/main.php?id=2954

6. Instituto Nacional de Meteorologia Temperaturas diárias. disponível em URL: http://reia.inmet.gov.br/graficos/ss00200400383781200508.gif

7. Gomolin IH, et al. Older is colder: temperature range and variation in older people. J Am Geriatr Soc 2005 dec; 53(12): 2170-2.

8. Kenney WL, Munce TA. Invited review: aging and human temperature regulation. J Appl Physiol 2003 dec; 95(6): 2598-603.

9. Van Someren EJ. Thermoregulation and aging. Am. J. Physiol Regul. Integr. Comp Physiol 2007 jan; 292(1): R99-102.

10. Gorzoni ML, Pires SL. Idosos asilados em hospitais gerais. Rev Saude Publica 2006 dec; 40(6): 1124-30.

11. Mallet ML. Pathophysiology of accidental hypothermia. QJM 2002 dec; 95(12): 775-85.

12. Eriksson H, et al. Body temperature in general population samples. The study of men born in 1913 and 1923. Acta Med Scand 1985; 217(4): 347-52.

13. Marion GS, McGann KP, Camp DL. Core body temperature in the elderly and factors which influence its measurement. Gerontology 1991; 37(4): 225-32. 14. McGann KP, et al. The influence of gender and race on mean body temperature in a population of healthy older adults. Arch Fam Med 1993 dec; 2(12): 1265-7.

14. Darowski A, Weinberg JR, Guz A. Normal rectal, auditory canal, sublingual and axillary temperatures in elderly afebrile patients in a warm environment. Age Ageing 1991 mar; 20(3): 113-9.

15. Smitz S, et al. Comparison of rectal and infrared ear temperatures in older hospital inpatients. J Am Geriatr Soc. 2000 jan; 48(1): 63-6.

16. Castle SC, et al. Fever response in elderly nursing. J Am Geriatr Soc 1991 sep; 39(9): 853-7.

17. Gomolin IH, Lester P, Pollack S. Older is colder: observations on body temperature among nursing home subjects. J Am Med Dir Assoc 2007 jun; 8(5): 335-7.

18. Darowski A, et al. The febrile response to mild infections in elderly hospital inpatients. Age Ageing 1991 may; 20(3): 193-8.

19. Smith LS. Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults - A comparison study. BMC Nurs 2003 jun; 2(1): 1.

20. Sund-Levander M, et al. Errors in body temperature assessment related to individual variation, measuring technique and equipment. Int J Nurs Pract 2004 oct; 10(5): 216-23.

21. Gubin DG, et al. The circadian body temperature rhythm in the elderly: effect of single daily melatonin dosing. Chronobiol Int 2006 nov; 23(3): 639-58.

22. Roghmann MC, Warner J, Mackowiak PA. The relationship between age and fever magnitude. Am J Med Sci 2001 aug; 322(2): 68-70.

23. Davies SP, et al. A comparison of mercury and digital clinical thermometers. J Adv Nurs 1986 sep; 11(5): 535-43.

24. Yoshikawa TT, Norman DC. Fever in the elderly. Infect Med 1998; 15(10): 704-8.

Recebido: 21/8/2009

Aprovado: 19/1/2010

Correspondência / Correspondence Milton Luiz Gorzoni Hospital Geriátrico e de Convalescentes Dom Pedro II Av Guapira, 2674 02265-002 - São Paulo,SP, Brasil E-mail: gorzoni@uol.com.br

Referências bibliográficas

1. Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992 sep; 268(12): 1578-80.
2. Pearce JM. A brief history of the clinical thermometer. QJM. 2002 Apr; 95(4): 251-2.
3. Sund-Levander M, Forsberg C, Wahren LK. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand J Caring Sci 2002 jun; 16(2): 122-8.
4. Katz S, et al. Progress in development in the index of ADL. Gerontologist 1970 apr; 10(1): 20-30.
5. Mallari B. Temperature. University of Illinois Medical Center: Health Library. disponível em URL: http://uimc.discoveryhospital.com/main.php?id=2954
6. Instituto Nacional de Meteorologia Temperaturas diárias. disponível em URL: http://reia.inmet.gov.br/graficos/ss00200400383781200508.gif
7. Gomolin IH, et al. Older is colder: temperature range and variation in older people. J Am Geriatr Soc 2005 dec; 53(12): 2170-2.
8. Kenney WL, Munce TA. Invited review: aging and human temperature regulation. J Appl Physiol 2003 dec; 95(6): 2598-603.
9. Van Someren EJ. Thermoregulation and aging. Am. J. Physiol Regul. Integr. Comp Physiol 2007 jan; 292(1): R99-102.
10. Gorzoni ML, Pires SL. Idosos asilados em hospitais gerais. Rev Saude Publica 2006 dec; 40(6): 1124-30.
11. Mallet ML. Pathophysiology of accidental hypothermia. QJM 2002 dec; 95(12): 775-85.
12. Eriksson H, et al. Body temperature in general population samples. The study of men born in 1913 and 1923. Acta Med Scand 1985; 217(4): 347-52.
13. Marion GS, McGann KP, Camp DL. Core body temperature in the elderly and factors which influence its measurement. Gerontology 1991; 37(4): 225-32.
14. McGann KP, et al. The influence of gender and race on mean body temperature in a population of healthy older adults. Arch Fam Med 1993 dec; 2(12): 1265-7.
14. Darowski A, Weinberg JR, Guz A. Normal rectal, auditory canal, sublingual and axillary temperatures in elderly afebrile patients in a warm environment. Age Ageing 1991 mar; 20(3): 113-9.
15. Smitz S, et al. Comparison of rectal and infrared ear temperatures in older hospital inpatients. J Am Geriatr Soc. 2000 jan; 48(1): 63-6.
16. Castle SC, et al. Fever response in elderly nursing. J Am Geriatr Soc 1991 sep; 39(9): 853-7.
17. Gomolin IH, Lester P, Pollack S. Older is colder: observations on body temperature among nursing home subjects. J Am Med Dir Assoc 2007 jun; 8(5): 335-7.
18. Darowski A, et al. The febrile response to mild infections in elderly hospital inpatients. Age Ageing 1991 may; 20(3): 193-8.
19. Smith LS. Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults - A comparison study. BMC Nurs 2003 jun; 2(1): 1.
20. Sund-Levander M, et al. Errors in body temperature assessment related to individual variation, measuring technique and equipment. Int J Nurs Pract 2004 oct; 10(5): 216-23.
21. Gubin DG, et al. The circadian body temperature rhythm in the elderly: effect of single daily melatonin dosing. Chronobiol Int 2006 nov; 23(3): 639-58.
22. Roghmann MC, Warner J, Mackowiak PA. The relationship between age and fever magnitude. Am J Med Sci 2001 aug; 322(2): 68-70.
23. Davies SP, et al. A comparison of mercury and digital clinical thermometers. J Adv Nurs 1986 sep; 11(5): 535-43.
24. Yoshikawa TT, Norman DC. Fever in the elderly. Infect Med 1998; 15(10): 704-8.

Datas de Publicação

Publicação nesta coleção
23 Out 2014
Data do Fascículo
Ago 2010

Histórico

Recebido
21 Ago 2009
Aceito
19 Jan 2010

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] 1. Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992 sep; 268(12): 1578-80.

[2] 2. Pearce JM. A brief history of the clinical thermometer. QJM. 2002 Apr; 95(4): 251-2.

[3] 3. Sund-Levander M, Forsberg C, Wahren LK. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand J Caring Sci 2002 jun; 16(2): 122-8.

[4] 4. Katz S, et al. Progress in development in the index of ADL. Gerontologist 1970 apr; 10(1): 20-30.

[5] 5. Mallari B. Temperature. University of Illinois Medical Center: Health Library. disponível em URL: http://uimc.discoveryhospital.com/main.php?id=2954

[6] 6. Instituto Nacional de Meteorologia Temperaturas diárias. disponível em URL: http://reia.inmet.gov.br/graficos/ss00200400383781200508.gif

[7] 7. Gomolin IH, et al. Older is colder: temperature range and variation in older people. J Am Geriatr Soc 2005 dec; 53(12): 2170-2.

[8] 8. Kenney WL, Munce TA. Invited review: aging and human temperature regulation. J Appl Physiol 2003 dec; 95(6): 2598-603.

[9] 9. Van Someren EJ. Thermoregulation and aging. Am. J. Physiol Regul. Integr. Comp Physiol 2007 jan; 292(1): R99-102.

[10] 10. Gorzoni ML, Pires SL. Idosos asilados em hospitais gerais. Rev Saude Publica 2006 dec; 40(6): 1124-30.

[11] 11. Mallet ML. Pathophysiology of accidental hypothermia. QJM 2002 dec; 95(12): 775-85.

[12] 12. Eriksson H, et al. Body temperature in general population samples. The study of men born in 1913 and 1923. Acta Med Scand 1985; 217(4): 347-52.

[13] 13. Marion GS, McGann KP, Camp DL. Core body temperature in the elderly and factors which influence its measurement. Gerontology 1991; 37(4): 225-32.

[14] 14. McGann KP, et al. The influence of gender and race on mean body temperature in a population of healthy older adults. Arch Fam Med 1993 dec; 2(12): 1265-7.

[15] 14. Darowski A, Weinberg JR, Guz A. Normal rectal, auditory canal, sublingual and axillary temperatures in elderly afebrile patients in a warm environment. Age Ageing 1991 mar; 20(3): 113-9.

[16] 15. Smitz S, et al. Comparison of rectal and infrared ear temperatures in older hospital inpatients. J Am Geriatr Soc. 2000 jan; 48(1): 63-6.

[17] 16. Castle SC, et al. Fever response in elderly nursing. J Am Geriatr Soc 1991 sep; 39(9): 853-7.

[18] 17. Gomolin IH, Lester P, Pollack S. Older is colder: observations on body temperature among nursing home subjects. J Am Med Dir Assoc 2007 jun; 8(5): 335-7.

[19] 18. Darowski A, et al. The febrile response to mild infections in elderly hospital inpatients. Age Ageing 1991 may; 20(3): 193-8.

[20] 19. Smith LS. Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults - A comparison study. BMC Nurs 2003 jun; 2(1): 1.

[21] 20. Sund-Levander M, et al. Errors in body temperature assessment related to individual variation, measuring technique and equipment. Int J Nurs Pract 2004 oct; 10(5): 216-23.

[22] 21. Gubin DG, et al. The circadian body temperature rhythm in the elderly: effect of single daily melatonin dosing. Chronobiol Int 2006 nov; 23(3): 639-58.

[23] 22. Roghmann MC, Warner J, Mackowiak PA. The relationship between age and fever magnitude. Am J Med Sci 2001 aug; 322(2): 68-70.

[24] 23. Davies SP, et al. A comparison of mercury and digital clinical thermometers. J Adv Nurs 1986 sep; 11(5): 535-43.

[25] 24. Yoshikawa TT, Norman DC. Fever in the elderly. Infect Med 1998; 15(10): 704-8.