Abstract
The risk of cardiopulmonary arrest (CPA) while taking a hot bath has long been recognized in the elderly. Although extensive studies have been conducted concerning the prevention of such events in the elderly, an effective system of prevention and care has yet to be developed. We conducted a retrospective investigation of 71 elderly patients, aged 65 and over, who were treated at Kitasato University Hospital Emergency Center from April 1987 to March 1997 for incurring CPA while taking a bath. This investigation revealed: 1) over the course of the ten-year period, the mean yearly incidence tended to increase (7.1 persons); 2) CPA during bathing occurred twice as frequently in women as men; 3) many of the patients had a pre-existing condition such as hypertension (46.3%) or diabetes mellitus (27.8%); 4) sixty-three (98.4%) of the patients had already undergone CPA by the time emergency personnel had arrived. All 71 patients died (mortality was 100%); 5) this phenomenon occurred 14 to 20 times more frequently during the winter months between 20:00 and 24:00 hours than during the summer months; 6) in all cases, CPA occurred while the subjects were bathing him-or herself. The time taken to find the subjects averaged 43.9±33.2 minutes as reported by the family members. Transfer time from the bath to our emergency center took approximately 31.5±12.8 minutes; 7) only three patients were reported to have consumed alcohol before taking a bath; 8) among 22 patients (75.9%) on whom an autopsy was performed, the primary cause of CPA was ischemic heart failure due to coronary sclerosis in 15 cases (68.2%), and also, subarachnoid hemorrhage recognized in one case and acute aortic dissection in one case (4.5%).
