Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia.
Rev Environ Health. 2023 Aug 4;39(4):729-736. doi: 10.1515/reveh-2023-0059. Print 2024 Dec 17.
Heat exhaustion (HE) is a common, yet obscure, heat-related illness that affects millions of people yearly and its burden is projected to rise due to climate change. A comprehensive literature synthesis is lacking despite previous studies on various HE aspects. This systematic review aims to fill this gap by identifying and synthesizing available evidence on the risk factors, symptoms, biomarkers, treatment options, and outcomes for HE. The review focused on HE during the Muslim (Hajj) pilgrimage where the condition is endemic. We conducted a structured search of MEDLINE/PubMed, Embase, Web of Science Core Collection, SCOPUS, and CINAHL databases. We summarized the data from eligible studies and synthesized them in narrative form using pooled descriptive statistics. Ten studies were included between 1980 and 2019, reporting over 1,194 HE cases. HE cases presented with elevated core temperature (up to 40°C) and mainly affected older males from the Middle East and North Africa region, with overweight individuals at a higher risk. Clinical symptoms included hyperventilation, fatigue, dizziness, headaches, nausea, and vomiting, but not central nervous system disturbances. HE was associated with cardiac stress, and with water, electrolyte, and acid-base alterations. Cooling and hydration therapy were the primary management strategies, leading to a low mortality rate (pooled case fatality rate=0.11 % [95 % CI: 0.01, 0.3]). Most cases recovered within a few hours without complications. HE is associated with cardiac stress and changes in homeostasis, leading to distinct clinical symptoms. Early diagnosis and treatment of HE are crucial in reducing the risk of complications and mortality. The review provides insights into the pathophysiology and outcomes of HE, adding to the scarce literature on the subject. Prospero registration number: CRD42022325759.
热衰竭（HE）是一种常见但鲜为人知的与热相关的疾病，每年影响数百万人，由于气候变化，其负担预计将增加。尽管之前有关于各种 HE 方面的研究，但缺乏全面的文献综合。本系统评价旨在通过确定和综合有关 HE 的危险因素、症状、生物标志物、治疗选择和结局的现有证据来填补这一空白。该综述重点关注穆斯林（朝觐）朝圣期间的 HE，这种情况在当地流行。我们对 MEDLINE/PubMed、Embase、Web of Science Core Collection、SCOPUS 和 CINAHL 数据库进行了结构化搜索。我们总结了合格研究的数据，并使用汇总描述性统计数据以叙述形式对其进行了综合。1980 年至 2019 年期间纳入了 10 项研究，报告了超过 1194 例 HE 病例。HE 病例表现为核心体温升高（高达 40°C），主要影响来自中东和北非地区的老年男性，超重个体风险更高。临床症状包括过度通气、疲劳、头晕、头痛、恶心和呕吐，但没有中枢神经系统紊乱。HE 与心脏应激以及水、电解质和酸碱平衡改变有关。冷却和水化治疗是主要的治疗策略，导致死亡率较低（汇总病例死亡率=0.11%[95%CI：0.01，0.3]）。大多数病例在数小时内康复，没有并发症。HE 与心脏应激和体内平衡变化有关，导致独特的临床症状。早期诊断和治疗 HE 对于降低并发症和死亡率的风险至关重要。该综述提供了对 HE 的病理生理学和结局的见解，增加了关于该主题的稀缺文献。前瞻性注册编号：CRD42022325759。
