Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study

Area of Science:

• Critical Care Medicine
• Hematology
• Emergency Medicine

Background:

• Severe heatstroke frequently leads to disseminated intravascular coagulation (DIC).
• Understanding the role of platelet function in heatstroke-associated DIC is crucial for patient management.
• Thromboelastography (TEG) offers a method to assess coagulation and platelet function.

Purpose of the Study:

• To evaluate platelet function using TEG in patients with heatstroke.
• To correlate platelet function with the severity of DIC in heatstroke patients.
• To determine the utility of TEG in diagnosing DIC in heatstroke.

Main Methods:

• Retrospective cohort study of 31 heatstroke patients admitted to the ICU.
• Platelet function assessed by the difference between citrated functional fibrinogen-maximum amplitude (CFF-MA) and citrated rapid TEG-maximum amplitude (CRT-MA) via TEG.
• DIC diagnosis based on the Japanese Association of Acute Medicine score (≥4).

Main Results:

• Platelet function, measured by CFF-MA-CRT-MA, was significantly correlated with DIC score (R = -0.63, p < 0.001).
• TEG-based platelet function assessment showed a strong association with DIC development (AUC 0.87).
• Median platelet function was 34.4 mm (IQR: 27.8-37.8 mm).

Conclusions:

• Platelet dysfunction is a key feature of heatstroke-induced DIC.
• TEG provides valuable complementary information for assessing platelet function in heatstroke.
• This evaluation can enhance the understanding of heatstroke subtypes and DIC pathophysiology.