title: Report of 182 cases of exertional heatstroke in the French Armed Forces.
abstract: OBJECTIVE
  Exertional heatstroke (EHS) remains a major problem for the military. The aim of our study was to describe medical history and clinical and biological features of EHS in a large military cohort.
  
  
  METHODS
  We conducted a retrospective study among military subjects admitted to the Military Teaching Hospital Laveran for EHS from 2004 to 2006.
  
  
  RESULTS
  Of the 182 subjects, EHS occurred most often at the end (80%) of a timed race of 8 km in battle clothes (84%) between the months of May and October (87%). The subjects were physically fit. Motivation was the primary intrinsic factor reported. A previous episode of EHS was reported by 15.4% of the subjects. Comas or seizures occurred more frequently in subjects whose temperatures exceeded 41°C (p = 0.03). Alanine aminotransferase was consistently increased in subjects who experienced EHS. We observed acute renal failure in 31.3% of the subjects, liver insufficiency in 12%, and disseminated intravascular coagulation in 1%. High creatine kinase levels alone did not correlate with renal failure.
  
  
  CONCLUSIONS
  Detection of severe EHS in the field before the onset of multiple organ failure is challenging. The determination of the factors contributing to recurrence is urgently needed as EHS remains a life-threatening condition.
authors.affiliation: Paris Fire Brigade Health Service, 12 rue Henri Regnault, 92400 Courbevoie, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Abriat
authors.affiliation: Military Teaching Hospital Laveran, BP 60149, 13384 Marseille Cedex 13, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Brosset
authors.affiliation: Military Teaching Hospital Laveran, BP 60149, 13384 Marseille Cedex 13, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Brégigeon
authors.affiliation: Military Teaching Hospital Laveran, BP 60149, 13384 Marseille Cedex 13, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Sagui
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D018883:Heat Stroke / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult