Mortality of patients with heatstroke admitted to intensive care units during the 2003 heat wave in France: a national multiple-center risk-factor study.
OBJECTIVE
Heatstroke requires active body cooling and organ failure supportive care. Although heat waves are expected to recur over the next decades, little is known about the risk factors for mortality in heatstroke patients. We examined the prognosis and risk factors for hospital mortality in patients with heatstroke admitted to an intensive care unit (ICU) during the heat wave in France in August 2003.


METHODS
A questionnaire was sent to the physicians leading an ICU in France to identify the patients admitted with heatstroke during August 2003. Data included demographics, factors predisposing to heatstroke, severity during the first day in the ICU, air conditioning in the ICU, and hospital mortality. Risk factors for mortality were determined in multivariate Cox proportional hazards analysis.


METHODS
None.


RESULTS
Data were obtained for 345 patients. Hospital mortality was 62.6%. Occurrence of heatstroke at home or in a healthcare facility rather than in a public location, high Simplified Acute Physiology Score II, high body temperature, prolonged prothrombin time, use of vasoactive drugs within the first day in the ICU, and patient management in an ICU without air conditioning were independently associated with an increased risk of death.


CONCLUSIONS
Mortality of patients admitted to the ICU with heatstroke is high. Predictors of mortality are available within the first 24 hrs after admission. Furthermore, in this study, air conditioning in the ICU was associated with improved outcome.
Misset
Benoît
B
Intensive Care Unit, Fondation Hôpital Saint-Joseph, Paris, France.
De Jonghe
Bernard
B
Bastuji-Garin
Sylvie
S
Gattolliat
Olivier
O
Boughrara
Ezzeddine
E
Annane
Djillali
D
Hausfater
Pierre
P
Garrouste-Orgeas
Maïté
M
Carlet
Jean
J
D000368:Aged; D005260:Female; D005602:France; D018883:Heat Stroke / Q000401:mortality*; D006358:Hot Temperature; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors