Donham Benjamin P, Frankfurt Sheila B, Cartier Rudolph A, O'Hara Sean M, Sieg Vanessa C
Department of Emergency Medicine, Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave, Fort Hood, TX 76544.
VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, Waco, TX 76711.
Mil Med. 2020 Jan 7;185(Suppl 1):362-367. doi: 10.1093/milmed/usz214.
The goal of the current study was to characterize the rate and estimate associated mortality and morbidity of exertional heat stroke (EHS) in U.S. military service members.
The current study was a retrospective cohort medical chart review study of all active-duty U.S. military service members, hospitalized with EHS at any MTF in the world between January1, 2007 and July 1, 2014. Enrolled patients were identified by altered mental status and elevated temperatures associated with physical exercise.
Out of 607 service members with an International Classification of Disease code indicating any type of heat injury, 48 service members met inclusion criteria for EHS. Core temperature was M = 105.8°F (41°C), standard deviation = 1.43, 90% were diagnosed with EHS prior to hospitalization, and 71% received prehospital cooling. Meantime to normothermia post-hospitalization was 56 minutes (standard deviation = 79.28). Acute kidney injury was diagnosed in 40% of patients although none developed hyperkalemia or required dialysis. Disseminated intravascular coagulation was rare (4%, n = 2) and overall observed mortality was very low (2%, n = 1).
EHS is aggressively identified and treated in U.S. Military Treatment Facilities. Mortality and morbidity were strikingly low.
本研究的目的是描述美国现役军人运动性中暑（EHS）的发生率，并估算相关的死亡率和发病率。
本研究是一项回顾性队列医学图表审查研究，研究对象为2007年1月1日至2014年7月1日期间在全球任何军事治疗机构住院治疗的所有美国现役军人，这些军人因运动性中暑而入院。通过精神状态改变和与体育锻炼相关的体温升高来确定入选患者。
在607名患有国际疾病分类代码表明有任何类型热损伤的军人中，48名军人符合运动性中暑的纳入标准。核心体温为M = 105.8°F（41°C），标准差 = 1.43，90%的患者在住院前被诊断为运动性中暑，71%的患者接受了院前降温。住院后恢复正常体温的平均时间为56分钟（标准差 = 79.28）。40%的患者被诊断为急性肾损伤，尽管没有人出现高钾血症或需要透析。弥散性血管内凝血很少见（4%，n = 2），总体观察到的死亡率非常低（2%，n = 1）。
在美国军事治疗机构中，运动性中暑能够得到积极的识别和治疗。死亡率和发病率极低。
