Intensive Care Medicine

, Volume 36, Issue 2, pp 272–280

Prognostic factors in non-exertional heatstroke

Authors

    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris
    • Service d’Accueil des UrgencesGroupe Hospitalier Pitié-Salpêtrière
  • Bruno Megarbane
    • Critical Care DepartmentCentre Hospitalo-Universitaire (CHU) Lariboisière, Assistance-Publique Hôpitaux de Paris
  • Sandrine Dautheville
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Tenon, Assistance-Publique Hôpitaux de Paris
  • Anabella Patzak
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) George Pompidou, Assistance-Publique Hôpitaux de Paris
  • Marc Andronikof
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Antoine Béclère, Assistance-Publique Hôpitaux de Paris
  • Aline Santin
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Henri Mondor, Assistance-Publique Hôpitaux de Paris
  • Stéphanie André
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Cochin-St Vincent de Paul, Assistance-Publique Hôpitaux de Paris
  • Ludovic Korchia
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Ambroise Paré, Assistance-Publique Hôpitaux de Paris
  • Nabila Terbaoui
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Bichat-Claude Bernard, Assistance-Publique Hôpitaux de Paris
  • Gérald Kierzek
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Hôtel Dieu, Assistance-Publique Hôpitaux de Paris
  • Benoît Doumenc
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Bicêtre, Assistance-Publique Hôpitaux de Paris
  • Christophe Leroy
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Louis Mourier, Assistance-Publique Hôpitaux de Paris
  • Bruno Riou
    • Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris
Original

DOI: 10.1007/s00134-009-1694-y

Cite this article as:
Hausfater, P., Megarbane, B., Dautheville, S. et al. Intensive Care Med (2010) 36: 272. doi:10.1007/s00134-009-1694-y

Abstract

Purpose

To identify the prognostic factors associated with mortality in heat-related illness.

Methods

Multi-center observational cohort-study in 16 emergency departments (ED) belonging to the teaching hospital network of the Paris area. The cohort comprised all patients admitted to one of the EDs during the August 2003 heat wave in Paris and having a core temperature >38.5°C. Baseline clinical and biological data in ED, patient’s course and 1-year survival rate were recorded. Potential prognostic factors associated with death were assessed by Cox proportional-hazards analysis.

Results

A total of 1,456 patients were included. Mean age was 79 ± 19 years. Critically ill conditions were noted in 391 patients (27%), but only 72 (5%) were admitted into an intensive care unit. The survival rate was 57% at 1 year as compared to an expected 90% (P < 0.001). Nine independent prognostic factors were identified: previous treatment with diuretics, living in an institution, age >80 years, cardiac disease, cancer, core temperature >40°C, systolic arterial pressure <100 mmHg, Glasgow coma scale <12 and transportation to hospital by ambulance. We defined three risk groups: low, intermediate and high risk, with a 1-year survival rate of 85, 61 and 18%, respectively.

Conclusions

We observed a low survival rate and developed a risk score based on easily obtained variables that may be useful to clinicians managing casualties from future heat waves.

Keywords

HeatstrokeHeat waveRisk factorsElderly patientsMortalityTemperature

Copyright information

© Copyright jointly hold by Springer and ESICM 2009