Clinical Characteristics and Prognosis of Exertional Heat Stroke in Elderly Patients

YANG Xinjun; WANG Jinghua; WANG Lihui; CHEN Yunshuang; WANG Tianyi; HUANG Xudong; ZHAO Wei; ZHANG Chao

doi:10.3969/j.issn.1002-3429.2024.15.011

Abstract：Objective To investigate the clinical characteristics and prognosis of elderly patients with exertional heat stroke(EHS).Methods The clinical data of 9 elderly patients with EHS treated from January 2015 to December 2022 were retrospectively analyzed as observation group and 24 young patients with EHS served as control group.Hospitalization days and core body temperature were recorded in the two groups,and blood routine and biochemical indexes of the two groups were de-tected.The occurrence of complications in the two groups was observed.The clinical characteristics and prognosis of elderly patients with EHS were analyzed and compared,and the therapeutic effect of blood purification on patients with EHS was eval-uated.Results Serum B-type natriuretic peptide precursor in observation group was higher than that in control group at ad-mission,while serum creatinine,albumin and platelet were lower than those in control group(P＜0.05,P＜0.01).There was no significant difference in the levels of blood urea nitrogen,creatine kinase,lactate dehydrogenase(LDH),amylase,al-anine aminotransferase(ALT),myoglobin,and white blood cells(WBC)between the two groups(P＞0.05).The propor-tions of rhabdomyolysis,liver function impairment,cardiac insufficiency,hypoproteinemia and infection in observation group were significantly higher than those in control group(P＜0.05,P＜0.01).At discharge,LDH,ALT,and myoglobin levels in the observation group were lower than those at admission,and the blood albumin levels were lower than norma;the levels of LDH and WBC in the observation group were higher than those in the control group,while the levels of creatinine and blood albumin were lower than those in the control group(P＜0.05,P＜0.01).Three patients in each group were treated with re-nal replacement therapy(RRT),and renal function indexes were normal at discharge.There was no significant difference in length of hospital stay between the two groups(P＞0.05).The proportion of cured patients in control group was significantly higher than that in observation group at discharge(P＜0.05).Conclusion Elderly EHS patients are prone to complications such as rhabdomyolysis,liver function impairment,cardiac insufficiency,hypoproteinemia,and infection.Recovery from muscle injury and liver function impairment and nutritional recovery are slower than those of young patients.Severe EHS pa-tients complicated with acute kidney injury and multiple organ dysfunction syndrome should be treated with RRT early accord-ing to their condition to play a synergistic therapeutic effect,which is beneficial to improvement of prognosis and increase in the success rate of rescue.