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Outcomes after environmental hyperthermia.

Frank LoVecchio1, Anthony F Pizon, Christopher Berrett

  • 1Banner Good Samaritan Regional Poison, Phoenix, AZ 85006, USA. frank.lovecchio@bannerhealth.com

The American Journal of Emergency Medicine
|May 15, 2007
PubMed
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Environmental hyperthermia is a serious condition. Patients with higher temperatures, low blood pressure, or low Glasgow Coma Scale scores upon arrival were more likely to die from heat-related illnesses.

Area of Science:

  • Emergency Medicine
  • Environmental Health
  • Clinical Toxicology

Background:

  • Environmental hyperthermia, including heat stroke and heat exhaustion, poses a significant public health risk, particularly during extreme weather events.
  • Prompt recognition and management in the emergency department (ED) are crucial for improving patient outcomes.

Purpose of the Study:

  • To characterize patients presenting to the ED with presumed environmental hyperthermia.
  • To identify factors associated with mortality in this patient population.

Main Methods:

  • A retrospective chart review was conducted across two institutions.
  • Patients with discharge diagnoses of hyperthermia, heat stroke, heat exhaustion, or heat cramps were included, excluding those with alternative causes for hyperthermia.

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  • Data on demographics, comorbidities, vital signs, laboratory results, and outcomes were systematically collected and analyzed.

    • Main Results:

    • The study included 52 patients with a mean age of 42.6 years, presenting with a mean body temperature of 105.1°F.
    • A significant proportion of patients had altered mental status (Glasgow Coma Scale < 14 in 69.2%), elevated creatinine (40.4%), elevated creatine kinase (67.3%), and coagulopathy (57.7%).
    • Substance involvement (ethanol or illicit drugs) was noted in 34.6% of cases, with a mean hospital stay of 4.7 days and a mortality rate of 28.8%.

    Conclusions:

    • Higher initial body temperatures, hypotension, and lower Glasgow Coma Scale scores were significant predictors of mortality in patients with environmental hyperthermia.
    • These findings underscore the severity of environmental hyperthermia and the need for rapid assessment and intervention in the ED.