Abstract 19103: Prognostic Factor for Cardiac Dysfunction in Severe Patients With Heat Stroke

Introduction: Heat stroke is defined by failure of thermoregulation and central nervous abnormalities as a result of high core body temperature from exposure to high temperatures or hard exercise. The cardiovascular system is one of the most vital targets with heat stroke, and the early prediction for cardiovascular dysfunction is very important.

Hypothesis: We aimed to investigate the prognostic value of numerous factors and scoring system for predicting cardiac function in emergency patients with heat stroke.

Methods: We analyzed the data and clinical outcomes of the patients with heat stroke who were admitted from 2017 to 2021. Glasgow Coma Scale (GCS) was measured based on the patient's level of consciousness and responsiveness, and the APACHE (Acute Physiology and Chronic Health Evaluation) score was calculated by vital signs, GCS, and laboratory data on admission. Clinical variables including echocardiogram were compared according to the median, and receiver operating characteristic (ROC) curve for predicting critical outcomes such as death, ventilator, and dialysis were analyzed.

Results: We enrolled 67 patients (60 ± 21year-old, 52 males). The median of APACHE score and GCS were 16.3 and 11, and the patients were classified into two groups (high and low) by median respectively. In the low GCS group, left ventricle ejection fraction (LVEF) was lower and the proportion with wall motion abnormalities was higher ( p =0.008; 0.020). Also, LVEF was lower in the high-APACHE score group ( p= 0.046). ROC curve analysis for predicting critical outcomes showed that GCS and APACHE score had the highest area under the curve value of 0.744 and 0.734 ( p =0.001; 0.001).

Conclusions: Echocardiography should be recommended earlier for evaluating LV function in severe patients of heat stroke with lower GCS and higher APACHE score.