[Analysis of risk factors affecting prognosis of exertional heat stroke].
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.
Department of Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China. Corresponding author: Song Qing, Email: songqing3010301@sina.com.
Jia-jia
JJ
Zhao
Jing-jiang
JJ
Zhou
Jie
J
Hu
Fei-hu
FH
Zhou
Hong-jun
HJ
Kang
Hui
H
Liu
Liang
L
Pan
Qing
Q
Song
D058186:Acute Kidney Injury / Q000150:complications*; D000293:Adolescent; D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D018883:Heat Stroke / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult