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. 2020 Aug 25;9(8):4210-4215.
doi: 10.4103/jfmpc.jfmpc_690_20. eCollection 2020 Aug.

Heat-related illness-Clinical profile and predictors of outcome from a healthcare center in South India

George Abraham Ninan  1 , Karthik Gunasekaran  1 , Jonathan Arul Jeevan Jayakaran  1 , Jacob Johnson  1 , Kpp Abhilash  2 , Kishore Pichamuthu  3 , Ramya Iyadurai  1
Affiliations

Heat-related illness-Clinical profile and predictors of outcome from a healthcare center in South India

George Abraham Ninan et al. J Family Med Prim Care. .

Abstract

Background: 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.

Methods: 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.

Results: 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 (P value < 0.029). The mortality rate associated with heat-related illness in this study was 11.1%.

Conclusions: 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.

Keywords: Air-conditioned heat stroke units; J-ERATO score; heat-related illness; outcome.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Figure depicting distribution of cases as red triangles in district of Vellore
Figure 2
Figure 2
Figure showing proportion of patients with multiple organ dysfunction syndrome and relative percentage of organs involved
Figure 3
Figure 3
Graph showing mortality of patients admitted with heat-related illness in same center over 2 decades
See this image and copyright information in PMC

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