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A novel indicator for temperature control in heat stroke treatment

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Title: A novel indicator for temperature control in heat stroke treatment
Authors: Jian Feng, Mingyang Tang, Meiting Gong, Fuxiang Li, Yunming Li, Bo Huang, Fan Feng, Xiong Wang, Haifeng Pei
Source: Precision Medical Sciences, Vol 13, Iss 1, Pp 21-28 (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: CTTP, heat stroke, inpatient death, organ damage, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background Temperature control plays a pivotal role in patients with heat stroke (HS), but little work has been done sufficiently on the use of temperature control to reflect disease progression. Here, we defined and analyzed the concrete role of controlling time for core temperature to physiological level (CTTP), in order to explore a potential index to guide the treatment of HS. Method This is a retrospective cohort study. From three hospitals located in Sichuan province, China, we collected a total of 179 HS cases with clinical diagnosis and treatment records. We defined CTTP as the time interval of HS onset to stabilization of core temperature (rectal temperature) below 37.7°C and analyzed the correlation between CTTP and inpatient death of HS patients. Results Of all the cases, 64.80% were male and 53.07% were exertional heat stroke (EHS). The median (IQR) age was 59 (23.5–73) years old, and the median (IQR) onset temperature was 42 (40.4–42)°C. Multivariable analysis demonstrated significantly high inpatient death in the highest CTTP tertile (>18 h) (hazard ratio: 18.75; 99% confidence interval: 4.06–86.59; p = .0002). In addition, compared with patients in lowest CTTP tertile, patients in highest CTTP tertile were at significantly higher risk of organ damage: 3.48‐fold for respiratory failure (95% CI: 1.41–8.59, p = .0069); 3.18‐fold for shock (95% CI: 1.37–7.39, p = .0071); 4.09‐fold for rhabdomyolysis (95% CI: 1.73–9.64, p = .0013); 4.64‐fold for renal damage (95% CI: 2.12–10.14, p = .0001). Conclusion Long of CTTP predicts inpatient death of HS patients with a CTTP tertile >18 h associated with the highest rate of inpatient death.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2642-2514
Relation: https://doaj.org/toc/2642-2514
DOI: 10.1002/prm2.12123
Access URL: https://doaj.org/article/c71ef0a947b1495194d0540e5a2af254
Accession Number: edsdoj.71ef0a947b1495194d0540e5a2af254
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  Data: <searchLink fieldCode="AR" term="%22Jian+Feng%22">Jian Feng</searchLink><br /><searchLink fieldCode="AR" term="%22Mingyang+Tang%22">Mingyang Tang</searchLink><br /><searchLink fieldCode="AR" term="%22Meiting+Gong%22">Meiting Gong</searchLink><br /><searchLink fieldCode="AR" term="%22Fuxiang+Li%22">Fuxiang Li</searchLink><br /><searchLink fieldCode="AR" term="%22Yunming+Li%22">Yunming Li</searchLink><br /><searchLink fieldCode="AR" term="%22Bo+Huang%22">Bo Huang</searchLink><br /><searchLink fieldCode="AR" term="%22Fan+Feng%22">Fan Feng</searchLink><br /><searchLink fieldCode="AR" term="%22Xiong+Wang%22">Xiong Wang</searchLink><br /><searchLink fieldCode="AR" term="%22Haifeng+Pei%22">Haifeng Pei</searchLink>
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  Data: Precision Medical Sciences, Vol 13, Iss 1, Pp 21-28 (2024)
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  Data: <searchLink fieldCode="DE" term="%22CTTP%22">CTTP</searchLink><br /><searchLink fieldCode="DE" term="%22heat+stroke%22">heat stroke</searchLink><br /><searchLink fieldCode="DE" term="%22inpatient+death%22">inpatient death</searchLink><br /><searchLink fieldCode="DE" term="%22organ+damage%22">organ damage</searchLink><br /><searchLink fieldCode="DE" term="%22Neoplasms%2E+Tumors%2E+Oncology%2E+Including+cancer+and+carcinogens%22">Neoplasms. Tumors. Oncology. Including cancer and carcinogens</searchLink><br /><searchLink fieldCode="DE" term="%22RC254-282%22">RC254-282</searchLink>
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  Data: Abstract Background Temperature control plays a pivotal role in patients with heat stroke (HS), but little work has been done sufficiently on the use of temperature control to reflect disease progression. Here, we defined and analyzed the concrete role of controlling time for core temperature to physiological level (CTTP), in order to explore a potential index to guide the treatment of HS. Method This is a retrospective cohort study. From three hospitals located in Sichuan province, China, we collected a total of 179 HS cases with clinical diagnosis and treatment records. We defined CTTP as the time interval of HS onset to stabilization of core temperature (rectal temperature) below 37.7°C and analyzed the correlation between CTTP and inpatient death of HS patients. Results Of all the cases, 64.80% were male and 53.07% were exertional heat stroke (EHS). The median (IQR) age was 59 (23.5–73) years old, and the median (IQR) onset temperature was 42 (40.4–42)°C. Multivariable analysis demonstrated significantly high inpatient death in the highest CTTP tertile (>18 h) (hazard ratio: 18.75; 99% confidence interval: 4.06–86.59; p = .0002). In addition, compared with patients in lowest CTTP tertile, patients in highest CTTP tertile were at significantly higher risk of organ damage: 3.48‐fold for respiratory failure (95% CI: 1.41–8.59, p = .0069); 3.18‐fold for shock (95% CI: 1.37–7.39, p = .0071); 4.09‐fold for rhabdomyolysis (95% CI: 1.73–9.64, p = .0013); 4.64‐fold for renal damage (95% CI: 2.12–10.14, p = .0001). Conclusion Long of CTTP predicts inpatient death of HS patients with a CTTP tertile >18 h associated with the highest rate of inpatient death.
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