Exertional heat stroke (EHS) is becoming more understood, yet there is a lack of clinical data to support risk-stratifying EHS patients. Finding a suitable scoring system for EHS prognostic evaluation was researchers’ main goal for a study.
All EHS patients hospitalized in the intensive care unit (ICU) of the General Hospital of Southern Theatre Command of the PLA between October 2008 and May 2019 were included in the retrospective cohort analysis. Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS) scores, inflammatory indices, and organ function measurements were all gathered at the time of admission. With the use of a multivariate Cox proportional hazard risk regression model, risk variables for 90-day mortality were found.
Finally, 189 patients (all male) were included; 21 years (IQR 19.0–27.0), their median APACHE II score was 11.0 (IQR 8.0–16.0), their median SOFA score was 3.0 (IQR 2.0–6.0), and their median GCS score was 12.0 (IQR 7.0–14.0). There were 23 non-survivors (12.2%) compared to 166 survivors (87.8%). Rhabdomyolysis (46.1% vs. 63.6%), disseminated intravascular coagulation (25.6% vs. 90.0%), acute liver injury (69.4% vs. 95.7%), and acute kidney injury (36.6% vs. 95.7%) were among the serious organ injuries that were more common in non-survivors than in the survivor group. A multivariate Cox risk regression model with an ideal cutoff score of 7.5 revealed that the SOFA score was an independent risk factor for 90-day death.
A clinically relevant predictor of mortality in EHS may be the SOFA score. The best cutoff level and the usefulness of the SOFA score must be confirmed by prospective research.
Reference: sciencedirect.com/science/article/abs/pii/S0735675722005447
