title: Predictive Factors for Hospitalization of Patients with Heat Illness in Yamaguchi, Japan.
abstract: The objective of the study was to investigate the predictive factors for the hospitalization of patients who presented with mild to moderate heat illness at an emergency department. We conducted a retrospective survey of hospitals with an emergency department in Yamaguchi Prefecture, Japan. The survey questionnaire entries included patient age, sex, use of an ambulance, vital signs, blood examination conducted at the emergency department, the length of hospitalization, and outcome. We analyzed the predictive factors for hospitalization in patients with heat illness. A total of 127 patients were analyzed. Of these, 49 (37%) were admitted, with 59% discharged on the day following admission. In univariate analysis, the following inpatient characteristics were predictive for hospitalization: old age, low Glasgow Coma Scale score, elevated body temperature, increased serum C-reactive protein, and increased blood urea nitrogen. In logistic regression multivariate analysis, the following were predictive factors for hospitalization: age of ≥ 65 years (odds ratio (OR) 4.91; 95% confidence interval (CI) 1.42-17.00), body temperature (OR 1.97; 95% CI 1.14-3.41), Glasgow Coma Scale (OR 0.40; 95% CI 0.16-0.98), and creatinine (OR 2.92; 95% CI 1.23-6.94). The results suggest that the elderly with hyperthermia, disturbance of consciousness, and elevated serum creatinine have an increased risk for hospitalization with heat illness.
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. tak-y@yamaguchi-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. todani-ygc@umin.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Todani
authors.affiliation: Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. yasutaka-ygc@umin.ac.jp.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Oda
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. kaneyui-ygc@umin.ac.jp.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. kouta-ygc@umin.ac.jp.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kaneda
authors.affiliation: Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. motoki-ygc@umin.ac.jp.
authors.forename: Motoki
authors.initials: M
authors.lastname: Fujita
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. miyauchi-ygc@umin.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyauchi
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. motoki-ygc@umin.ac.jp.|Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. motoki-ygc@umin.ac.jp.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tsuruta
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D018882:Heat Stress Disorders / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: consciousness disturbance; dehydration; elderly; elevated body temperature; heat exhaustion; heat illness; heatstroke; hospitalization