Clinical features and risk factors of heat stroke patients with acute respiratory distress syndrome
Deng Peng
Gao Hongguang
Yang Ying
Sheng Jie
Luo Dong
Wang Hui
Meng Xiaoyan
Zhang Haihong
Yao Rong
Abstract：Objective To investigate the clinical characteristics and risk factors of acute respiratory distress syndrome(ARDS)in the patients with heat stroke(HS).Methods The clinical data of patients with HS who were admitted to the emergency departments of eight hospitals,including West China Hospital of Sichuan University,the Second Affiliated Hospital of Chengdu Medical College and so on,from 0:00 on August 1,2009 to 24:00 on September 30,2023 were retrospectively collected and analyzed.General information,vital signs at visit,laboratory examination results and treatment after admission were collected.The patients were divided into ARDS group and non-ARDS group according to whether ARDS occurred in hospital,and the clinical characteristics between the different groups were compared.Multivariate Logistic stepwise regression was used to screen variables,and prediction models were established and nomograms were drawn.Finally,the models were validated by receiver operating characteristic(ROC)curve and calibration curve.Results A total of 268 HS patients were enrolled in the study period,of which 56 patients met the diagnostic criteria for ARDS.Compared with non-ARDS patients,ARDS patients had significantly higher heart rate,serum creatinine,lactic acid,cardiac troponin T and international normalized ratio(INR)on admission,while lower mean arterial pressure,hematocrit,platelet count and calcium ion(all P＜0.05).Multivariate Logistic regression analysis showed that the decrease of hematocrit and calcium ion,the increase of lactate and cardiac troponin T were independent risk factors for ARDS in HS patients during hospitalization.A nomogram model was established based on these four indexes.The area under ROC curve of the prediction model was 0.724.The calibration curve showed that the actual prediction ability of the model was highly consistent with the ideal prediction ability.Conclusions Hematocrit,lactate,calcium ion and cardiac troponin T were independent risk factors for ARDS in HS patients.The prediction model based on these four indexes was effective for early identification of HS complicated with ARDS.
Keywords：Heat strokeAcute respiratory distress syndrome(ARDS)Clinical featuresPrediction modelHematocritLactateCalcium ionCardiac troponin T
Publication Date：2025-05-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 380-385 )