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. 2019 Dec;6(4):345-350.
doi: 10.15441/ceem.18.081. Epub 2019 Dec 31.

Predictors of poor prognosis in patients with heat stroke

Jae-Kwon Chun  1 , Sangchun Choi  1 , Hyuk-Hoon Kim  1 , Hee Won Yang  1 , Chang Seong Kim  2
Affiliations

Predictors of poor prognosis in patients with heat stroke

Jae-Kwon Chun et al. Clin Exp Emerg Med. 2019 Dec.

Abstract

Objective: The predictors of poor prognosis in heat stroke (HS) remain unknown. This study investigated the predictive factors of poor prognosis in patients with HS.

Methods: Data were obtained and analyzed from the health records of patients diagnosed with heat illness at Ajou university hospital between January 2008 and December 2017. Univariate and multivariate analyses were performed to identify the independent predictors of poor prognosis.

Results: Thirty-six patients (median age, 54.5 years; 33 men) were included in the study. Poor prognosis was identified in 27.8% of the study population (10 patients). The levels of S100B protein, troponin I, creatinine, alanine aminotransferase, and serum lactate were statistically significant in the univariate analysis. Multiple regression analysis revealed that poor prognosis was significantly associated with an increased S100B protein level (odds ratio, 177.37; 95% confidence interval, 2.59 to 12,143.80; P=0.016). The S100B protein cut-off level for predicting poor prognosis was 0.610 μg/L (area under the curve, 0.906; 95% confidence interval, 0.00 to 1.00), with 86% sensitivity and 86% specificity.

Conclusion: An increased S100B protein level on emergency department admission is an independent prognostic factor of poor prognosis in patients with HS. Elevation of the S100B protein level represents a potential target for specific and prompt therapies in these patients.

Keywords: Biomarkers; Heat stroke; Prognosis; S100B protein.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Comparison of S100B protein levels between the good and poor prognosis groups. The box plots show the median S100B protein levels in each group. The median level in the poor prognosis group is about five times higher than that in the good prognosis group (0.95 [0.62 to 2.52] vs 0.20 [0.14 to 0.47] µg/L; P<0.001).
Fig. 2.
Fig. 2.
Receiver operating characteristics curve for the S100B protein level and poor prognosis of heat stroke. An S100B protein level cut-off of 0.610 µg/L predicted poor prognosis in patients with heat stroke with 86% sensitivity and 86% specificity (area under the curve, 0.91 [95% confidence interval, 0.79 to 1.00]; p=0.001).
See this image and copyright information in PMC

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