Exertional Heat Illness Complications and Prognosis Among Service Members

Area of Science:

• Sports Medicine
• Environmental Health
• Military Health

Background:

• Exertional heat illness (EHI) poses significant health risks to active individuals.
• Understanding the spectrum of EHI complications and their long-term sequelae is critical for effective management and prevention.

Purpose of the Study:

• To investigate the various complications associated with exertional heat illness (EHI).
• To analyze the relationship between EHI complications and subsequent health outcomes, including medical separation and chronic disease development.

Main Methods:

• A retrospective cohort study analyzed 24,121 service members with first-time EHI between 2012 and 2022.
• Six key EHI complications were assessed: rhabdomyolysis, acute kidney injury (AKI), neurological symptoms, acidosis, respiratory/cardiovascular distress, and other organ damage.
• Clustering analysis identified distinct patterns of EHI complications.

Main Results:

• Six clusters of EHI complications were identified, with the majority (81%) experiencing mild cases without complications.
• Clusters involving acute kidney injury (AKI) and/or rhabdomyolysis were linked to male sex, obesity, and fewer pre-existing chronic conditions.
• A smaller cluster with neurological symptoms showed higher rates of females, pre-existing chronic conditions, and increased risk of medical separation.

Conclusions:

• Exertional heat illness (EHI) complications can be categorized into distinct clusters.
• These EHI clusters demonstrate varied associations with pre-injury demographics and medical history.
• The identified clusters are differentially linked to post-EHI outcomes, including medical separation and long-term health.