Citation

Zhao JJ, Zhou JJ, Hu J, Zhou FH, Kang HJ, Liu H, Pan L, Song Q. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2013; 25(9): 515-518.

Affiliation

Department of Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China. Corresponding author: Song Qing, Email: songqing3010301@sina.com.

Copyright

(Copyright © 2013, Zhonghua yi xue za zhi)

DOI

10.3760/cma.j.issn.2095-4352.2013.09.002

PMID

24059414

Abstract

OBJECTIVE: To determine prognostic risk factors of exertional heat stroke (EHS). METHODS: Sixty-nine patients who met the case definition of EHS at ten military hospitals from June 2002 to August 2012 were enrolled in this retrospective study. The clinical data and prognosis was observed, including rhabdomyolysis (RM), disseminated intravascular coagulation (DIC), acute kidney injury (AKI), hepatosis, epilepsy, shock, arrhythmia, multiple organ dysfunction syndrome (MODS) and consciousness disorder. A logistic regression analysis was made to look for the significant risk factors, and its accuracy and reliability were tested and verified by statistical equation. RESULTS: There were 69 patients with EHS in the study, and 18 (26.09%) were dead. The independent prognostic factors were identified as DIC and AKI [DIC odds ratio (OR)=94.994, 95% confidence interval (95%CI) 3.837-2352.031, P=0.005; AKI OR=90.871, 95%CI 2.079-3971.995, P=0.019]. The mortality was 16.67% (3/18) when any one factor exist; the mortality was 93.75% (15/16) when two factors exist (sensibility was 83.33%; with specificity of 98.03%, positive predictive value of 93.75%, negative predictive value of 94.34%, and accuracy of 94.20%). CONCLUSIONS: Among all the clinical parameters, the major risk factors affecting prognosis of EHS included DIC and AKI. The mortality might go very high if both two risk factors exist.

Language: zh