Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience  

作　　者：Li Zhong Ming Wu Zhe-Ying Liu Yan Liu Zhi-Feng Liu 

机构地区：[1]Department of Traditional Chinese Medicine,The First Affiliated Hospital,Guizhou University of Chinese Medicine,Guiyang,550001,China [2]Department of Infection and Critical Care Medicine,The Second People's Hospital of Shenzhen&First Affiliated Hospital of Shenzhen University,Health Science Center,Shenzhen,Guangdong province,518035,China [3]Department of Medical Critical Care Medicine,General Hospital of Southem Theatre Command of PLA.Guangzhou,510010,China [4]Guangdong Branch Center,National Clinical Research Center for Geriatric Diseases(Chinese PLA General Hospital),Guangzhou,510010,China

出　　处：《Chinese Journal of Traumatology》2024年第2期91-96,共6页中华创伤杂志（英文版）

基　　金：supported by grants from the National Natural Science Foundation of China[NO.82072143,82360903];Natural Science Foundation of Guangdong Province(2021A1515010170);The grants from the Guizhou Science and Technology Planning Project[Guizhou Science and Technology Cooperation Support(2021)General 413];PhD start-up fund of Guizhou University of Traditional Chinese Medicine[GYZYYFY-BS-2023(09)].

摘　　要：Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients wi

关 键 词：Exertional heatstroke Brain injury SEQUELA Risk factors Disorders of consciousness 

分 类 号：R651.15[医药卫生—外科学]