J Korean Soc Emerg Med.  2018 Aug;29(4):319-325. 10.0000/jksem.2018.29.4.319.

Analysis of the clinical features and laboratory findings according to the outcome for detecting early prognostic factors of heat stroke patients

• Chung HS
• Do BS
• Lee SB
• Kim JH

• KMID: 2435484
• DOI: http://doi.org/10.0000/jksem.2018.29.4.319

Abstract

OBJECTIVE
Heat stroke is a serious heat-related illness characterized by elevated core body temperature and an impaired central nervous system. Heat stroke can also cause various complications and lead to irremediable results. However, early prediction of its outcome remains difficult. In this study, we analyzed clinical features and laboratory findings according to the outcome of heat stroke patients and tried to identify factors that predict their prognosis in the acute stage.
METHODS
In this retrospective observational study, we enrolled 40 heat stroke patients who arrived at five emergency departments in Daegu within three hours from the time at which heat stroke occurred every June 1 to August 31 from 2011 to 2016. In addition, we compared the clinical features and laboratory findings according to the outcome.
RESULTS
The mean ages were 72.0 (53.0-76.0) in the good outcome group (GOG) and 57.0 (39.5-84.8) in the poor outcome group (POG). In addition, there were 23 (71.9%) and five (62.5%) men in the GOG and the POG, respectively. Among clinical characteristics, initial neurological status and endotracheal intubation differed significantly by prognosis (P=0.019 and P=0.001, respectively). Among laboratory findings, arterial bicarbonate ion level, platelet count, and aspartate aminotransferase level were differed significantly by prognosis (P=0.003, P=0.005, and P=0.009, respectively).
CONCLUSION
An initial decline in consciousness, conducting endotracheal intubation, decreased arterial bicarbonate ion level or platelet count, as well as increased aspartate aminotransferase levels were poor prognosis factors of heat stroke patients in the acute stage. Emergency physicians should be careful when managing these patients.

Keyword

Climate change; Heat stroke; Prognostic factors

MeSH Terms

Aspartate Aminotransferases
Bicarbonates
Body Temperature
Central Nervous System
Climate Change
Consciousness
Daegu
Emergencies
Emergency Service, Hospital
Heat Stroke*
Hot Temperature*
Humans
Intubation, Intratracheal
Male
Observational Study
Platelet Count
Prognosis
Retrospective Studies
Aspartate Aminotransferases
Bicarbonates