Prognostic nomogram for heat stroke patients based on rapidly accessible clinical indicators

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Clinical Prognostics

Background:

• Heat stroke (HS) is a life-threatening condition requiring prompt risk stratification.
• Existing scoring systems may not be optimal for rapid assessment in emergency settings.

Purpose of the Study:

• To develop and validate a rapid-assessment scoring system for predicting in-hospital mortality in heat stroke patients.
• To facilitate early identification and intervention for critical heat stroke cases.

Main Methods:

• Retrospective cohort analysis of 307 heat stroke patients from 13 hospitals.
• Utilized Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariable logistic regression.
• Developed and validated a prognostic nomogram using creatinine, Glasgow Coma Scale, oxygenation index, and fibrin degradation products.

Main Results:

• The developed nomogram demonstrated strong discriminative capacity for mortality risk stratification (AUC 0.811 in training, 0.766 in validation).
• The nomogram's AUC (0.794) was superior to the SOFA score (0.703) and comparable to the APACHE II score (0.765).
• Decision curve analysis indicated superior net benefit compared to existing systems.

Conclusions:

• A novel, clinically implementable prognostic tool for heat stroke mortality was developed and validated.
• This tool utilizes routinely available emergency department parameters for rapid bedside application.
• The system offers comparable accuracy to established intensive care scores, enabling timely therapeutic decisions.