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Predictors of multi-organ dysfunction in heatstroke.

G M Varghese1, G John, K Thomas

  • 1Christian Medical College, Vellore, Department of Medicine Unit 2, Vellore, India, 632004. georgemvarghese@hotmail.com

Emergency Medicine Journal : EMJ
|March 1, 2005
PubMed
Summary

Heatstroke can cause multi-organ dysfunction, especially respiratory failure. High CPK, metabolic acidosis, and elevated liver enzymes predict this severe outcome in heatstroke patients.

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Area of Science:

  • Environmental Medicine
  • Critical Care Medicine
  • Toxicology

Background:

  • Heatstroke is a life-threatening condition characterized by a core body temperature exceeding 40°C due to thermoregulatory failure.
  • It leads to multi-organ dysfunction and carries a high mortality rate, with survivors at risk of permanent neurological damage.

Purpose of the Study:

  • To identify predictors of multiple organ dysfunction syndrome (MODS) in patients diagnosed with heatstroke.
  • To analyze clinical and laboratory data to understand factors contributing to severe outcomes in heatstroke.

Main Methods:

  • A retrospective study of 28 patients admitted to a hospital in southern India between January 1998 and December 2001.
  • Data collected included patient characteristics, laboratory results, and outcomes.

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  • Patients were compared based on the presence or absence of multiple organ dysfunction.

    • Main Results:

    • Over 75% of studied patients developed multiple organ dysfunction, with respiratory failure being the most common.
    • Metabolic acidosis (87.5%), elevated creatine phosphokinase (CPK) (89.5%), and liver enzymes elevated more than twice the normal (61%) were significantly correlated with dysfunction in two or more organs.
    • These findings highlight key biomarkers associated with severe heatstroke complications.

    Conclusions:

    • Multi-organ dysfunction is the primary driver of mortality in heatstroke.
    • Elevated CPK levels (>1000 IU/l), metabolic acidosis, and increased liver enzymes are significant predictors of MODS in heatstroke.
    • Prompt body temperature reduction and supportive therapies are crucial for improving survival rates.