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Exertional Heat Illness Recovery and Recurrence
Josh B Kazman1,2,3,4, D Alan Nelson5, Anwar E Ahmed4
1Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Military Medicine
|September 24, 2025
Summary
A prior history of exertional heat illness (EHI) is rare but significantly increases the risk of recurrence in soldiers. Clinical factors like duty restriction duration do not predict recurrent EHI, highlighting the importance of prior diagnosis.
Area of Science:
- Military Medicine
- Environmental Health
- Sports Medicine
Background:
- Exertional heat illness (EHI) poses a significant risk to military personnel readiness.
- Predicting and preventing EHI recurrence is crucial for minimizing lost duty time.
- Limited research exists on factors influencing EHI recurrence.
Purpose of the Study:
- To identify characteristics associated with EHI duty restrictions.
- To predict EHI recurrence and prognosis in US Army soldiers.
- To inform strategies for managing EHI and its long-term impact.
Main Methods:
- Retrospective cohort study of 1,742 US Army soldiers diagnosed with EHI.
- Analysis of EHI complications, medical history, and demographics.
- Investigation of associations between prior EHI and recurrence risk.
Main Results:
- 4.4% of soldiers experienced recurrent EHI.
- A prior EHI diagnosis was a strong predictor of recurrence (HRadj: 7.37).
- Clinical complications and profile duration were not significantly associated with recurrence risk.
Conclusions:
- Prior EHI is a rare but potent risk factor for subsequent EHI in soldiers.
- Clinical characteristics of the initial EHI episode do not predict recurrence.
- Further research is needed to understand EHI severity's role in return to duty.
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