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

Chung, Han Sol; Do, Byung Soo; Lee, Sam Beom; Kim, Jung Ho

J Korean Soc Emerg Med > Volume 29(4); 2018 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2018;29(4): 319-325.

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

Han Sol Chung, Byung Soo Do, Sam Beom Lee

, Jung Ho Kim

Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea

Correspondence

Jung Ho Kim ,Tel: 053-620-3193, Fax: 053-623-8030, Email: jhkimem@naver.com,

Received: June 1, 2018; Revised: July 25, 2018 Accepted: July 30, 2018. Published online: August 31, 2018.

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.

Key words: Climate change; Heat stroke; Prognostic factors