Clinical Characteristics of Heatstroke and Analysis of Factors Affecting Prognosis
Objective:To investigate the clinical characteristics and the related factors affecting the prognosis of heatstroke(HS).Methods:The clinical data of 80 patients with HS admitted in our hospital from July 2015 to September 2020 were retrospectively analyzed.The general demographic data,clinical char-acteristics,laboratory test indicators,treatment and outcome were collected.The last follow-up time was Jan-uary 2023.HS was divided into exertional HS group(n=71)and classical HS group(n=9)according to the state of onset and pathogenesis.The two groups of patients were compared in terms of general data and labora-tory indicators.The patients were divided into survival group(n=66)and death group(n=14)according to their prognosis,and regression analysis was performed on the prognostic factors.Results:Of the 80 HS pa-tients,71 were EHS and 9 were CHS,of whom 5 had a history of hypertension.HS patients were more likely to develop the disease in July-August,with 41 cases(51.25%)in July,26 cases(32.50%)in August,and 13 cases(16.25%)in September.The proportion of patients with a body temperature≥40℃,shock,and coma was significantly higher in the EHS group than in the CHS group(P<0.05).The proportions of patients with convulsions,incontinence,arrhythmia,and ataxia were not significantly different between the two groups(P>0.05).Compared with the CHS group,the EHS group had lower levels of alanine aminotransferase(ALT),activated partial thromboplastin time(APTT),fibrinogen,and potassium,but higher levels of D-di-mer,aspartate aminotransferase(AST),prothrombin time(PT),and calcium(P<0.05).There was no sig-nificant difference in white blood cell count,platelet count,creatinine,or myoglobin between the two groups(P>0.05).Compared with the death group,the survival group had lower levels of white blood cell count,platelet count,D-dimer,AST,ALT,creatinine,PT,APTT,and potassium,but higher levels of calcium(P<0.05).There was no significant difference in myoglobin or fibrinogen between the two groups(P>0.05).Logistic multivariate analysis showed that D-dimer and calcium were significantly associated with the prognosis of HS(P<0.05).Conclusion:D-dimer and serum calcium are independent prognostic factors of HS,and can be used as prognostic indicators.Early monitoring of hematological indicators in HS patients is helpful to take corresponding treatment measures.
万方数据
维普
