A newly proposed heatstroke-induced coagulopathy score in patients with heat illness: A multicenter retrospective study in China  

作　　者：Qing-Wei Lin Lin-Cui Zhong Long-Ping He Qing-Bo Zeng Wei Zhang Qing Song Jing-Chun Song 

机构地区：[1]Department of Critical Care Medicine,The 908th Hospital of Chinese PLA Logistic Support Forces,Nanchang,360104,Jiangsu Province,China [2]Department of Emergency Medicine,The 900th Hospital of Chinese PLA Logistic Support Forces,Fuzhou,350000,China [3]Department of Critical Care Medicine,Hainan Hospital of Chinese PLA General Hospital,Sanya,572013,Hainan Province,China

出　　处：《Chinese Journal of Traumatology》2024年第2期83-90,共8页中华创伤杂志（英文版）

基　　金：funded by Chinese Medicine Education Association(No.2022KTz013).

摘　　要：Purpose:In patients with heatstroke, disseminated intravascular coagulation (DIC) is associated with greater risk of in-hospital mortality. However, time-consuming assays or a complex diagnostic system may delay immediate treatment. Therefore, the present study proposes a new heatstroke-induced coagulopathy (HIC) score in patients with heat illness as an early warning indicator for DIC.Methods:This retrospective study enrolled patients with heat illness in 24 Chinese hospitals from March 2021 to May 2022. Patients under 18 years old, with a congenital clotting disorder or liver disease, or using anticoagulants were excluded. Data were collected on demographic characteristics, routine blood tests, conventional coagulation assays and biochemical indexes. The risk factors related to coagulation function in heatstroke were identified by regression analysis, and used to construct a scoring system for HIC. The data of patients who met the diagnostic criteria for HIC and International Society on Thrombosis and Haemostasis defined-DIC were analyzed. All statistical analyses were performed using SPSS 26.0.Results:The final analysis included 302 patients with heat illness, of whom 131 (43.4%) suffered from heatstroke, including 7 death (5.3%). Core temperature (OR = 1.681, 95% CI 1.291 - 2.189, p < 0.001), prothrombin time (OR = 1.427, 95% CI 1.175 - 1.733, p < 0.001) and D-dimer (OR = 1.242, 95% CI 1.049 - 1.471, p = 0.012) were independent risk factors for heatstroke, and therefore used to construct an HIC scoring system because of their close relation with abnormal coagulation. A total score ≥ 3 indicated HIC, and HIC scores correlated with the score for International Society of Thrombosis and Hemostasis-DIC (r = 0.8848, p < 0.001). The incidence of HIC (27.5%) was higher than that of DIC (11.2%) in all of 131 heatstroke patients. Meanwhile, the mortality rate of HIC (19.4%) was lower than that of DIC (46.7%). When HIC developed into DIC, parameters of coagulation dysfunction changed significantly: platelet count decr

关 键 词：Heat illness HEATSTROKE Coagulation disorders Diagnosis Disseminated intravascular coagulation 

分 类 号：R446.11[医药卫生—诊断学]