title: The effect of pre-existing medical conditions on heat stroke during hot weather in South Korea.
abstract: BACKGROUND
  Heat stroke contributes considerably to morbidity and mortality in hot weather, but it is unclear whether pre-existing medical conditions increase the risk of heat stroke. The purpose of this study was to assess the association between heat stroke and pre-existing medical conditions in South Korea.
  
  
  METHODS
  A case-control study was conducted using data from a nationwide surveillance system for heat illnesses in 2012. Individuals with heat stroke were identified and compared to control subjects with mild heat illness such as heat exhaustion, heat edema, heat cramps, and heat syncope. Categories of pre-existing medical conditions included cardio/cerebrovascular disease, respiratory disease, neuropsychiatric disorder, and diabetes mellitus. Associations between heat stroke and pre-existing medical conditions were assessed by multivariate logistic regression analyses.
  
  
  RESULTS
  Of 968 eligible patients, 178 (18.4%) presented with heat stroke. Patients with pre-existing medical conditions were relatively greater in the heat stroke group than in the control group (40.4% and 23.9%, respectively). Neuropsychiatric disorder was associated with an increased odds of heat stroke after adjustment for covariates (adjusted odds ratio, 7.69; 95% CI, 4.06-14.54). There were no significant relationships between heat stroke and other medical conditions (cardio/cerebrovascular disease: 0.66, 0.40-1.06; respiratory disease: 1.44, 0.35-5.89; diabetes mellitus: 1.16, 0.58-2.34).
  
  
  CONCLUSIONS
  Pre-existing neuropsychiatric disorder was associated with an increased risk of heat stroke. National strategies and clinical guidance for such patients should be initiated to prevent fatal events.
authors: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, San-5 Wonchon-dong, Youngtong-gu, Suwon, South Korea; Division of Infectious Disease Control, Korea Centers for Disease Control and Prevention, Osongsaengmyeong2-ro, Osong-eup, Cheongwon-gun, Chungbuk, South Korea.
authors: Si-Heon
authors: SH
authors: Kim
authors: Climate Change Adaptation Task Force, Korea Centers for Disease Control and Prevention, Osongsaengmyeong2-ro, Osong-eup, Cheongwon-gun, Chungbuk, South Korea.
authors: Soo-Nam
authors: SN
authors: Jo
authors: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, San-5 Wonchon-dong, Youngtong-gu, Suwon, South Korea.
authors: Hyung-Nam
authors: HN
authors: Myung
authors: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, San-5 Wonchon-dong, Youngtong-gu, Suwon, South Korea. Electronic address: free5293@gmail.com.
authors: Jae-Yeon
authors: JY
authors: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D018883:Heat Stroke / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult
keywords: Climate change; Heat stroke; Heat waves; Neuropsychiatric disorder; Pre-existing medical conditions