Rapid cooling in classic heatstroke: effect on mortality rates

The case records of 39 patients with classic (non-exertional) heatstroke presenting to an urban emergency department were reviewed. Eight of 39 patients died. Rapid cooling, defined as a rectal temperature of less than or equal to 38.9 degrees C (102 degrees F) within an hour of presentation, was achieved in 27 of 39 patients. Twelve patients had a temperature greater than or equal to 38.9 degrees C (102 degrees F) after one hour of treatment in the emergency department. The rate of mortality in the rapid cooling group was four of 27 (15%), while in the delayed cooling group, the mortality rate was four of 12 (33%) (P = 0.18). Factors such as advanced age, hypotension, altered coagulation status, and the necessity for endotracheal intubation on presentation dictated a poor outcome despite successful cooling measures.