Characteristics and Outcome of Exertional Heatstroke Patients Complicated by Acute Hepatic Injury:A Cohort Study  

作　　者：Jingjing Ji Jinghua Gao Conglin Wang Leifang Ouyang Zheying Liu Zhifeng Liu 

机构地区：[1]Department of Critical Care Medicine,General Hospital of Southern Theater Command of PLA,Guangzhou,Guangdong,China [2]Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA,General Hospital of Southern Theater Command of PLA,Guangzhou,Guangdong,China

出　　处：《Journal of Clinical and Translational Hepatology》2021年第5期655-660,共6页临床与转化肝病杂志（英文版）

基　　金：This work was supported by grants from the National Natural Science Foundation of China[No.82072143];the Natural Science Foundation of Guangdong Province of China[No.2021A1515010170];the PLA Logistics Research Project of China[Nos.18CXZ030,BLJ20J006].

摘　　要：Background and Aims:Exertional heatstroke(EHS)is associated with strenuous physical activity in hot environments.The present study aimed to investigate dynamic changes of hepatic function indices in EHS patients and determine risk factors for death.Methods:This single-center retrospective cohort study considered all patients with EHS admitted to the intensive care unit at the General Hospital of Southern Theater Command of PLA from October 2008 to May 2019.Data on general characteristics,organ function parameters,and the 90-day outcome of enrolled patients were collected.Hepatic indices were collected dynamically,and patients with acute hepatic injury(AHI)were identified by plasma total bilirubin(TBIL)≥34.2μmol/L and an international normalized ratio≥1.5,or with any grade of hepatic encephalopathy.Results:In patients who survived,TBIL,alanine aminotransferase and aspartate aminotransferase were increased at 24 h,peaked at 2–3 days,and began to decrease at 5 days.In non-survivors,TBIL continuously increased post-admission.The area under the receiver operating characteristic curve for the prediction of mortality based on sequential organ failure assessment(SOFA)scores was 89.8%,and the optimal cutoff value was 7.5.Myocardial injury and infection were identified as independent risk factors for death in EHS patients with AHI.Conclusions:In EHS patients,hepatic dysfunction usually occurred within 24 h.Patients with AHI had more severe clinical conditions,and significantly increased 90-day mortality rates.SOFA scores over 7.5,complicated with myocardial injury or infection,were found to be risk factors for death in EHS patients with AHI.

关 键 词：Exertional heatstroke Acute hepatic injury Mortality TBIL SOFA 

分 类 号：R73[医药卫生—肿瘤]