Ninan George Abraham, Gunasekaran Karthik, Jayakaran Jonathan Arul Jeevan, Johnson Jacob, Abhilash Kpp, Pichamuthu Kishore, Iyadurai Ramya
Department of General Medicine Unit V, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2020 Aug 25;9(8):4210-4215. doi: 10.4103/jfmpc.jfmpc_690_20. eCollection 2020 Aug.
Heat-related illness is a common medical emergency. There is failure of thermoregulatory mechanisms of the body resulting in multiple organ dysfunction syndrome which if not identified and treated urgently can result in high mortality rate and permanent neurological damage. This study provides description of clinical profile patients presenting with heat-related illness and identifies clinical and laboratory variables resulting in poor outcome.
This retrospective study was done identifying adult patients admitted with a diagnosis of heat-related illness from April to August 2019 in tertiary care center. Their clinical profile, laboratory investigations and outcome were extracted from medical records and variables associated with poor outcome were analyzed for statistical significance.
Mean age of the patients in the study was 61 years with mean heat index of the localities being 39.6-degree C. 66% of patients had multiple organ dysfunction with central nervous system dysfunction (77%) followed by respiratory distress syndrome (61%) as the most common organ derangement. Evaporative cooling measures were incorporated in management of all patients, followed by cold saline infusion in 60%. Higher J-ERATO score at admission was found to be a predictor for underlying multiple organ dysfunction syndrome ( value < 0.029). The mortality rate associated with heat-related illness in this study was 11.1%.
Multiple organ dysfunction is seen in majority of the patients and calculation of simple admission J-ERATO score helps in predicting the same. Declining mortality rate observed in our study as compared to the earlier studies could be attributed to increased awareness, prompt diagnosis and initiation of rapid cooling measures.
与热相关的疾病是一种常见的医疗急症。人体体温调节机制失灵会导致多器官功能障碍综合征，如果不能及时识别和治疗，可能会导致高死亡率和永久性神经损伤。本研究描述了患有与热相关疾病的患者的临床特征，并确定了导致不良预后的临床和实验室变量。
本回顾性研究纳入了2019年4月至8月在三级医疗中心因与热相关疾病诊断入院的成年患者。从病历中提取他们的临床特征、实验室检查结果和预后情况，并分析与不良预后相关的变量的统计学意义。
研究中患者的平均年龄为61岁，当地的平均热指数为39.6摄氏度。66%的患者有多器官功能障碍，其中中枢神经系统功能障碍最为常见（77%），其次是呼吸窘迫综合征（61%）。所有患者的治疗均采用了蒸发冷却措施，60%的患者随后接受了冷盐水输注。入院时较高的J-ERATO评分被发现是潜在多器官功能障碍综合征的一个预测指标（值<0.029）。本研究中与热相关疾病相关的死亡率为11.1%。
大多数患者出现多器官功能障碍，计算简单的入院J-ERATO评分有助于预测这一情况。与早期研究相比，我们的研究中观察到的死亡率下降可能归因于意识提高、诊断及时以及快速冷却措施的启动。
