Heatstroke: clinical signs, diagnosis, treatment, and prognosis.

Heatstroke is a complex disease process that, in its most severe form, can result in multiorgan dysfunction and death. Heatstroke stems from the failure of the body’s thermoregulatory mechanisms, resulting in cellular damage and death. The organ systems most commonly affected in this disease process include the gastrointestinal tract and the coagulation, renal, cardiac, pulmonary, and central nervous systems. Heatstroke is diagnosed based on the patient history, physical examination, and clinicopathologic findings. Treatment should be instituted immediately to improve patient outcome and includes active cooling, fluid resuscitation, and supportive care. Patients with altered mental status, hypoglycemia, prolonged prothrombin time, and prolonged activated partial thromboplastin time at admission have increased mortality rates. Additional negative prognostic indicators include elevated serum creatinine level, delayed admission to the hospital, seizures, and obesity.