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Performance of quick sequential organ failure assessment (qSOFA) score for prognosis of heat-related hospitalized patients

      Highlights

      • Heat-related illnesses pose significant threats to human health.
      • qSOFA score can be used as a parameter to distinguish severe hospitalized patients.
      • Multiple organ impairment should be considered when assessing patient prognosis.

      Abstract

      Background

      Heat-related illnesses pose significant threats to human health.

      Objectives

      (1) To evaluate the use of qSOFA score for prognosis of heat-related hospitalized patients; and (2) identify other predictors for patient prognosis.

      Methods

      Using 28-day mortality as the primary endpoint, a retrospective, observational study of patients hospitalized between June 2013 and September 2018 was conducted.

      Results

      The qSOFA score from 84 patients was identified as an independent predictor of patient prognosis. The area under the receiver operating characteristic curves for qSOFA score was 0.702, and a sensitivity of 100.00% and a specificity of 47.06% were found for qSOFA score greater than or equal to 2. Other predictors included bilirubin, urea nitrogen, and troponin I levels.

      Conclusions

      qSOFA score can be used as a parameter to distinguish patients with severe heat-related illness prior to further clinical analyses. In addition to that, multiple organ impairment should be considered when assessing patient prognosis.

      Keywords

      Abbreviations:

      HS (heat stroke), ICU (intensive care unit), qSOFA (Quick Sequential Organ Failure Assessment), SOFA score (sequential organ failure assessment score), ALT (alanine transaminase), AST (aspartate transaminase), TB (total bilirubin), CK (creatinine kinase), BUN (blood urea nitrogen), Cr (creatinine), WBC (white blood cell count), Hb (hemoglobin), PLT (platelet count), INR (international normalized ratio), TnI (troponin I), ROC curves (Receiver operating characteristic curves), AUROC (Area under the receiver operating characteristic curves)
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      References

        • Al Mahri S.
        • Bouchama A
        Heatstroke.
        Handb Clin Neurol. 2018; 157: 531-545
        • Abdelmoety D.A.
        • El-Bakri N.K.
        • Almowalld W.O.
        • et al.
        Characteristics of heat illness during Hajj: a cross-sectional study.
        Biomed Res Int. 2018; 20185629474
        • Lim C.L.
        Heat sepsis precedes heat toxicity in the pathophysiology of heat stroke-a new paradigm on an ancient disease.
        Antioxidants (Basel, Switzerland). 2018; 7: 149
        • Robine J.M.
        • Cheung S.L.
        • Le Roy S.
        • et al.
        Death toll exceeded 70,000 in Europe during the summer of 2003.
        C. R. Biol. 2008; 331: 171-178
        • Barriopedro D.
        • Fischer E.M.
        • Luterbacher J.
        • Trigo R.M.
        • Garcia-Herrera R
        The hot summer of 2010: redrawing the temperature record map of Europe.
        Science (New York, NY). 2011; 332: 220-224
        • Bouchama A.
        • Knochel J.P.
        Heat stroke.
        N Engl J Med. 2002; 346: 1978-1988
        • Hifumi T.
        • Kondo Y.
        • Shimazaki J.
        • et al.
        Prognostic significance of disseminated intravascular coagulation in patients with heat stroke in a nationwide registry.
        J Crit Care. 2018; 44: 306-311
        • Hausfater P.
        • Megarbane B.
        • Fabricatore L.
        • et al.
        Serum sodium abnormalities during nonexertional heatstroke: incidence and prognostic values.
        Am J Emerg Med. 2012; 30: 741-748
        • Hausfater P.
        • Doumenc B.
        • Chopin S.
        • et al.
        Elevation of cardiac troponin i during non-exertional heat-related illnesses in the context of a heatwave.
        Crit Care. 2010; 14: R99
        • Yamamoto T.
        • Todani M.
        • Oda Y.
        • et al.
        Predictive factors for hospitalization of patients with heat illness in Yamaguchi, Japan.
        Int J Environ Res Public Health. 2015; 12: 11770-11780
        • Hayashida K.
        • Kondo Y.
        • Hifumi T.
        • et al.
        A novel early risk assessment tool for detecting clinical outcomes in patients with heat-related illness (J-ERATO score): development and validation in independent cohorts in Japan.
        PLoS One. 2018; 13e0197032
        • Singer M.
        • Deutschman C.S.
        • Seymour C.W.
        • et al.
        The third international consensus definitions for sepsis and septic shock (Sepsis-3).
        JAMA. 2016; 315: 801-810
        • Seymour C.W.
        • Liu V.X.
        • Iwashyna T.J.
        • et al.
        Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3).
        JAMA. 2016; 315: 762-774
        • Churpek M.M.
        • Snyder A.
        • Han X.
        • et al.
        Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit.
        Am J Respir Crit Care Med. 2017; 195: 906-911
        • Yamamoto T.
        • Fujita M.
        • Oda Y.
        • et al.
        Evaluation of a novel classification of heat-related illnesses: a multicentre observational study (Heat stroke study 2012).
        Int J Environ Res Public Health. 2018; 15: E1962
        • Hausfater P.
        • Megarbane B.
        • Dautheville S.
        • et al.
        Prognostic factors in non-exertional heatstroke.
        Intensive Care Med. 2010; 36: 272-280
        • Pease S.
        • Bouadma L.
        • Kermarrec N.
        • Schortgen F.
        • Regnier B.
        • Wolff M
        Early organ dysfunction course, cooling time and outcome in classic heatstroke.
        Intensive Care Med. 2009; 35: 1454-1458
        • Fan H.
        • Zhao Y.
        • Zhu J.H.
        • et al.
        Thrombocytopenia as a predictor of severe acute kidney injury in patients with heat stroke.
        Ren Fail. 2015; 37: 877-881