Risk factors of early death in heat stroke and the challenges of emergency care in Hungary - a case series study.

IF 2 Q2 EMERGENCY MEDICINE
Kornél Ádám, Tamás Berényi, Dóra Melicher, Bánk G Fenyves, Szabolcs Gaál, Csaba Varga
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Abstract

Background and aim: The increasing frequency of heat waves worldwide is a major challenge for emergency care providers worldwide. The aim of this study was to analyze the clinical features, treatment options, and early outcomes of heat stroke patients presenting to a large academic emergency department (ED) in Hungary and to provide guidance in management for other emergency professionals.

Methods: Patients presenting to the ED between June 1, 2024, and July 31, 2024, with a body temperature above 40 °C were analyzed in a retrospective cohort study. Data collection included demographic, clinical and laboratory parameters. Predictors of mortality were analyzed with Mann-Whitney U test.

Results: Eight patients were included in our analysis. Three patients died in the ED (37.5%). Patients who died had significantly lower pH (7.07 vs. 7.4, p = 0.036), higher potassium (7.3 vs. 3.2 mmol/L, p = 0.036), higher calcium (1.19 vs. 0.97 mmol/L, p = 0.036), higher lactate (10.9 vs. 3.5 mmol/L, p = 0.036) and higher PaCO2 (57.2 vs. 28 mmHg, p = 0.036) at admission compared to those who did not die.

Conclusions: The risk of heat stroke due to climate change-induced heat stress and the consequent thermoregulatory disruption may now be significant in temperate climate zones where it was not previously present. Standardization of differential diagnostic and therapeutic procedures could reduce mortality. pH, potassium, lactate and calcium levels may play an important role in predicting the outcome of heat stroke.

匈牙利中暑过早死亡的风险因素和急救护理面临的挑战--病例系列研究。
背景和目的:全球热浪日益频繁,这对全球急诊护理人员来说是一项重大挑战。本研究旨在分析在匈牙利一家大型学术性急诊科(ED)就诊的中暑患者的临床特征、治疗方案和早期预后,并为其他急诊专业人员的管理提供指导:在一项回顾性队列研究中,对 2024 年 6 月 1 日至 2024 年 7 月 31 日期间到急诊科就诊、体温超过 40 ℃ 的患者进行了分析。数据收集包括人口统计学、临床和实验室参数。采用曼-惠特尼U检验分析了死亡率的预测因素:结果:八名患者纳入了我们的分析。三名患者在急诊室死亡(37.5%)。死亡患者的 pH 值明显降低(7.07 vs. 7.4,p = 0.036),血钾明显升高(7.3 vs. 3.2 mmol/L,p = 0.036),血钙明显升高(1.19 vs. 0.97 mmol/L,p = 0.036)、入院时乳酸更高(10.9 vs. 3.5 mmol/L,p = 0.036)、PaCO2更高(57.2 vs. 28 mmHg,p = 0.036):结论:气候变化引起的热应激和随之而来的体温调节紊乱导致的中暑风险现在可能在以前不存在的温带气候区非常严重。pH值、钾、乳酸和钙水平可能在预测中暑结果方面发挥重要作用。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
63
审稿时长
13 weeks
期刊介绍: The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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