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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

The Relationship Between 24-Hour Indicators and Mortality in Patients with Exertional Heat Stroke

Author(s): Shuyuan Liu, Ling Xing, Jinpeng Wang, Tianyu Xin, Handing Mao, Jinbao Zhao, Cong Li and Qing Song*

Volume 22, Issue 2, 2022

Published on: 22 January, 2021

Page: [241 - 246] Pages: 6

DOI: 10.2174/1871530321666210122153249

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Abstract

Background: Exertional heat stroke (EHS) is a life-threatening illness that can lead to multiple organ damage in the early stage.

Objective: This study aimed to investigate the relationship between 24-hour indicators and mortality in patients with EHS.

Methods: The records of EHS patients hospitalized were collected and divided into the death group and the survival group. We then analyzed the demographic characteristics and APACHE II scores and laboratory results of the participants in the blood within the first 24 h after hospitalization, and assessed whether these candidate indicators differed between the death group and the survival group. Cox regression analysis of the survival data was performed to explore the relationship between early indicators and prognosis.

Results: The levels of plasma PT, APTT, TT, and INR were significantly higher in the death group than in the survival group. The blood PLT count and the levels of PTA and Fb were significantly lower in the death group than in the survival group, while the levels of BU, SCr, ALT, AST, TBil, and DBil were significantly higher in the death group than in the survival group. Furthermore, the levels of Mb, LDH, TNI, and NT-proBNP were significantly higher in the death group than in the survival group, while there was no significant difference in CK levels between the two groups.

Conclusion: Patients with EHS often had multiple organ injuries in the early stage (within 24 h), while those cases in the death group were more severe.

Keywords: Exertional heat stroke, organ damage, mortality, prognosis, DIC, CHS.

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[1]
Yang, M.; Li, Z.; Zhao, Y.; Zhou, F.; Zhang, Y.; Gao, J.; Yin, T.; Hu, X.; Mao, Z.; Xiao, J.; Wang, L.; Liu, C.; Ma, L.; Yuan, Z.; Lv, J.; Shen, H.; Hou, P.C.; Kang, H. Outcome and risk factors associated with extent of central nervous system injury due to exertional heat stroke. Medicine (Baltimore), 2017, 96(44), e8417.
[http://dx.doi.org/10.1097/MD.0000000000008417] [PMID: 29095276]
[2]
Raukar, N.; Lemieux, R.S.; Casa, D.J.; Katch, R.K. Dead Heat: Treating exertional heat stroke is a race against time and temperature. JEMS, 2017, 42(5), 54-59.
[PMID: 29227612]
[3]
Varghese, G.M.; John, G.; Thomas, K.; Abraham, O.C.; Mathai, D. Predictors of multi-organ dysfunction in heatstroke. Emerg. Med. J., 2005, 22(3), 185-187.
[http://dx.doi.org/10.1136/emj.2003.009365] [PMID: 15735266]
[4]
Liu, S.Y.; Song, J.C.; Mao, H.D.; Zhao, J.B.; Song, Q. Expert Group of Heat Stroke Prevention and Treatment of the People’s Liberation Army, and People’s Liberation Army Professional Committee of Critical Care Medicine. Expert consensus on the diagnosis and treatment of heat stroke in China. Mil. Med. Res., 2020, 7(1), 1.
[http://dx.doi.org/10.1186/s40779-019-0229-2] [PMID: 31928528]
[5]
Bouchama, A.; Knochel, J.P. Heat stroke. N. Engl. J. Med., 2002, 346(25), 1978-1988.
[http://dx.doi.org/10.1056/NEJMra011089] [PMID: 12075060]
[6]
Epstein, Y.; Yanovich, R. Heatstroke. N. Engl. J. Med., 2019, 380(25), 2449-2459.
[http://dx.doi.org/10.1056/NEJMra1810762] [PMID: 31216400]
[7]
Liu, Z.; Sun, X.; Tang, J.; Tang, Y.; Tong, H.; Wen, Q.; Liu, Y.; Su, L. Intestinal inflammation and tissue injury in response to heat stress and cooling treatment in mice. Mol. Med. Rep., 2011, 4(3), 437-443.
[PMID: 21468589]
[8]
Yeh, C.H.; Chen, Z.C.; Hsu, C.C.; Lin, M.T.; Chen, C.C. Protection in rats with heatstroke: hyperbaric oxygen vs activated protein C therapy. Eur. J. Pharmacol., 2010, 635(1-3), 103-108.
[http://dx.doi.org/10.1016/j.ejphar.2010.01.013] [PMID: 20123096]
[9]
Roberts, G.T.; Ghebeh, H.; Chishti, M.A.; Al-Mohanna, F.; El-Sayed, R.; Al-Mohanna, F.; Bouchama, A. Microvascular injury, thrombosis, inflammation, and apoptosis in the pathogenesis of heatstroke: a study in baboon model. Arterioscler. Thromb. Vasc. Biol., 2008, 28(6), 1130-1136.
[http://dx.doi.org/10.1161/ATVBAHA.107.158709] [PMID: 18388331]
[10]
Leon, L.R.; Bouchama, A. Heat stroke. Compr. Physiol., 2015, 5(2), 611-647.
[http://dx.doi.org/10.1002/cphy.c140017] [PMID: 25880507]
[11]
Leon, LR; Helwig, BG Heat stroke: Role of the systemic inflammatory response. J Appl Physiol, 2010, 109(6), 1980-1988.
[12]
Asakura, H.; Suga, Y.; Yoshida, T.; Ontachi, Y.; Mizutani, T.; Kato, M.; Ito, T.; Morishita, E.; Yamazaki, M.; Miyamoto, K.; Nakao, S. Pathophysiology of disseminated intravascular coagulation (DIC) progresses at a different rate in tissue factor-induced and lipopolysaccharide-induced DIC models in rats. Blood Coagul. Fibrinolysis, 2003, 14(3), 221-228.
[http://dx.doi.org/10.1097/01.mbc.0000061290.28953.57] [PMID: 12695743]
[13]
Aquilina, A; Pirotta, T; Aquilina, A Acute liver failure and hepatic encephalopathy in exertional heat stroke. BMJ Case Rep., 2018.
[http://dx.doi.org/10.1136/bcr-2018-224808]
[14]
Heytens, K.; De Bleecker, J.; Verbrugghe, W.; Baets, J.; Heytens, L. Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation. World J. Crit. Care Med., 2017, 6(1), 21-27.
[http://dx.doi.org/10.5492/wjccm.v6.i1.21] [PMID: 28224104]
[15]
Grogan, H.; Hopkins, P.M. Heat stroke: implications for critical care and anaesthesia. Br. J. Anaesth., 2002, 88(5), 700-707.
[http://dx.doi.org/10.1093/bja/88.5.700] [PMID: 12067009]
[16]
Giercksky, T.; Boberg, K.M.; Farstad, I.N.; Halvorsen, S.; Schrumpf, E. Severe liver failure in exertional heat stroke. Scand. J. Gastroenterol., 1999, 34(8), 824-827.
[http://dx.doi.org/10.1080/003655299750025778] [PMID: 10499485]
[17]
Nakagawa, Y.; Inoue, H.; Shinone, K.; Ikemura, M.; Nata, M. Molecular biological analysis of cardiac effect of high temperature in rats. Leg. Med. (Tokyo), 2012, 14(2), 63-68.
[http://dx.doi.org/10.1016/j.legalmed.2011.12.001] [PMID: 22285644]
[18]
Yoshizawa, T.; Omori, K.; Takeuchi, I.; Miyoshi, Y.; Kido, H.; Takahashi, E.; Jitsuiki, K.; Ishikawa, K.; Ohsaka, H.; Sugita, M.; Yanagawa, Y. Heat stroke with bimodal rhabdomyolysis: a case report and review of the literature. J. Intensive Care, 2016, 4, 71.
[http://dx.doi.org/10.1186/s40560-016-0193-9] [PMID: 27980788]
[19]
Muñiz, A.E. Ischemic electrocardiographic changes and elevated troponin from severe heatstroke in an adolescent. Pediatr. Emerg. Care, 2012, 28(1), 64-67.
[http://dx.doi.org/10.1097/PEC.0b013e31823f2557] [PMID: 22217892]
[20]
King, MA; Leon, LR; Mustico, DL; Haines, JM; Clanton, TL Biomarkers of multiorgan injury in a preclinical model of exertional heat stroke. J Appl Physiol, 2015, 118(10), 1207-1220.

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