Intensive Care Medicine

, Volume 36, Issue 2, pp 272–280 | Cite as

Prognostic factors in non-exertional heatstroke

  • Pierre Hausfater
  • Bruno Megarbane
  • Sandrine Dautheville
  • Anabella Patzak
  • Marc Andronikof
  • Aline Santin
  • Stéphanie André
  • Ludovic Korchia
  • Nabila Terbaoui
  • Gérald Kierzek
  • Benoît Doumenc
  • Christophe Leroy
  • Bruno Riou



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


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.


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.


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.


Heatstroke Heat wave Risk factors Elderly patients Mortality Temperature 



We are indebted to Emmanuelle de Magondeau and Christine Lanau for their excellent data monitoring and management. We thank Dr. David J. Baker, DM, FRCA (Department of Anesthesiology, CHU Necker-Enfants Malades, Paris, France) for reviewing the manuscript and Prof. Paul Landais, MD, PhD (Department of Biostasistics, CHU Necker-Enfants Malades, France) and Yannick Le Manach (Department of Anesthesiology and Critical Care, CHU Pitié-Salpêtrière, Paris, France) for statistical advice. The study was supported by the Direction Régionale de la Recherche Clinique d’Ile de France (Paris, France), grant no. CRC 03-150.

Conflict of interest statement

The authors declare that they have no conflict of interest.


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Copyright information

© Copyright jointly hold by Springer and ESICM 2009

Authors and Affiliations

  • Pierre Hausfater
    • 1
    • 13
  • Bruno Megarbane
    • 2
  • Sandrine Dautheville
    • 3
  • Anabella Patzak
    • 4
  • Marc Andronikof
    • 5
  • Aline Santin
    • 6
  • Stéphanie André
    • 7
  • Ludovic Korchia
    • 8
  • Nabila Terbaoui
    • 9
  • Gérald Kierzek
    • 10
  • Benoît Doumenc
    • 11
  • Christophe Leroy
    • 12
  • Bruno Riou
    • 1
  1. 1.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Pitié-Salpêtrière, Assistance-Publique Hôpitaux de ParisParisFrance
  2. 2.Critical Care DepartmentCentre Hospitalo-Universitaire (CHU) Lariboisière, Assistance-Publique Hôpitaux de ParisParisFrance
  3. 3.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Tenon, Assistance-Publique Hôpitaux de ParisParisFrance
  4. 4.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) George Pompidou, Assistance-Publique Hôpitaux de ParisParisFrance
  5. 5.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Antoine Béclère, Assistance-Publique Hôpitaux de ParisClamartFrance
  6. 6.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Henri Mondor, Assistance-Publique Hôpitaux de ParisCréteilFrance
  7. 7.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Cochin-St Vincent de Paul, Assistance-Publique Hôpitaux de ParisParisFrance
  8. 8.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Ambroise Paré, Assistance-Publique Hôpitaux de ParisBoulogneFrance
  9. 9.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Bichat-Claude Bernard, Assistance-Publique Hôpitaux de ParisParisFrance
  10. 10.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Hôtel Dieu, Assistance-Publique Hôpitaux de ParisParisFrance
  11. 11.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Bicêtre, Assistance-Publique Hôpitaux de ParisLe Kremlin BicêtreFrance
  12. 12.Emergency DepartmentCentre Hospitalo-Universitaire (CHU) Louis Mourier, Assistance-Publique Hôpitaux de ParisColombesFrance
  13. 13.Service d’Accueil des UrgencesGroupe Hospitalier Pitié-SalpêtrièreParisFrance

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