Characteristics of pediatric patients with heat-related illness transferred to emergency departments: Descriptive analysis.

Background: Children are particularly vulnerable to heat-related illnesses due to their unique physiological and behavioral characteristics. Understanding the epidemiology and clinical features of heat-related illnesses in children is crucial for guiding targeted preventive measures and management strategies. This descriptive study aims to investigate the characteristics of pediatric patients with heat-related illness transferred to emergency department (ED) s in Japan.

Method: This study was a secondary analysis of the Heatstroke study, led by the Heatstroke and Hypothermia surveillance committee of the Japanese Association for Acute Medicine. This study included pediatric patients (<18 years old) with heat-related illness transferred to EDs in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes.

Results: Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range [IQR]: 13-16). Most cases occurred in August (47%) and most cases (80%) were associated with sports activities and with outdoor setting (70%). Cases with a body temperature above 40°C were rare (3%). Most cases were admitted to hospitals (75% to a general ward, and 16% to the ICU), and patients admitted to ICU had altered consciousness status with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrest.

Conclusion: Most pediatric cases with heat-related illness were middle or high school-aged, occurred in August and were related to outdoor sports activity. Patients admitted to hospitals suffered from altered consciousness status, dehydration and acute kidney injury.