Receiver Operating Characteristic Curve Analysis of the Value of Exertional Heat Stroke Score in Predicting the Prognosis of Exertional Heat Stroke Patients

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-05-01 DOI:10.1016/j.jemermed.2024.11.023

Heliang Ke MM , Dong Li MM , Yi Lin MM

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Abstract

Background

Exertional heat stroke (EHS) frequently affects individuals participating in high-intensity physical labor under conditions of elevated temperature and humidity. Therefore, it is essential to investigate the prognosis of EHS.

Objective

This study aims to evaluate the utility of the Exertional Heat Stroke Score (EHSS) system in predicting the prognosis of EHS patients by employing the receiver operating characteristic (ROC) curve.

Methods

We conducted a retrospective single-center analysis of 178 patients with EHS who were hospitalized between March 2020 and June 2023. These patients were categorized into two groups: those with poor prognosis and those with good prognosis, based on their prognostic outcomes. We compared the clinical data of both groups, including Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and EHSS scores. Additionally, we analyzed the predictive value of the EHSS system for the prognosis of EHS patients by constructing an ROC curve.

Results

Significant differences were observed between the poor prognosis group and the good prognosis group concerning several clinical parameters, including platelet count, urine creatinine, pH value, body temperature, lactate concentration, troponin I (TNL), prothrombin time, total bilirubin, fibrinogen, aspartate aminotransferase, and Glasgow Coma Scale. Additionally, the APACHE II and EHSS scores were notably higher in the poor prognosis group compared to the good prognosis group. The area under the curve (AUC) for the EHSS score in predicting the prognosis of EHS patients was 0.972, significantly surpassing the AUC of 0.872 for the APACHE II score.

Conclusion

The EHSS system accurately predicts the prognosis of EHS patients and has potential of clinical promotion to predict patient outcomes.

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劳累性中暑评分对劳累性中暑患者预后预测价值的受试者工作特征曲线分析

背景：在高温高湿条件下从事高强度体力劳动的个体经常发生中暑（EHS）。因此，研究EHS的预后是十分必要的。目的应用受试者工作特征（ROC）曲线，评价EHSS系统对EHS患者预后的预测价值。方法对2020年3月至2023年6月期间住院的178例EHS患者进行回顾性单中心分析。根据预后结果，将这些患者分为预后差和预后好的两组。我们比较了两组的临床数据，包括急性生理和慢性健康评估II （APACHE II）评分和EHSS评分。此外，我们通过构建ROC曲线来分析EHSS系统对EHS患者预后的预测价值。结果预后不良组与预后良好组在血小板计数、尿肌酐、pH值、体温、乳酸浓度、肌钙蛋白I （TNL）、凝血酶原时间、总胆红素、纤维蛋白原、天冬氨酸转氨酶、格拉斯哥昏迷量表等临床指标上均有显著差异。此外，预后不良组的APACHE II和EHSS评分明显高于预后良好组。EHSS评分预测EHS患者预后的曲线下面积（AUC）为0.972，显著高于APACHE II评分的AUC（0.872）。结论EHSS系统能准确预测EHS患者的预后，在预测患者预后方面具有临床推广潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine