A prehospital risk assessment tool predicts clinical outcomes in hospitalized patients with heat-related illness: a Japanese nationwide prospective observational study

We previously developed a risk assessment tool to predict outcomes after heat-related illness (J-ERATO score), which consists of six binary prehospital vital signs. We aimed to evaluate the ability of the score to predict clinical outcomes for hospitalized patients with heat-related illnesses. In a...

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Bibliographic Details
Published in:Scientific reports 2023-01, Vol.13 (1), p.1189-1189, Article 1189
Main Authors: Takegawa, Ryosuke, Kanda, Jun, Yaguchi, Arino, Yokobori, Shoji, Hayashida, Kei
Format: Article
Language:English
Subjects:
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Adult
Clinical outcomes
Disseminated intravascular coagulation
East Asian People
Emergency Medical Services
Heat
Heat Stress Disorders
Hospitalization
Hot Temperature
Humanities and Social Sciences
Humans
Mortality
multidisciplinary
Observational studies
Patients
Prognosis
Prospective Studies
Regression analysis
Retrospective Studies
Risk Assessment
ROC Curve
Science
Science (multidisciplinary)
Survival
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Summary:We previously developed a risk assessment tool to predict outcomes after heat-related illness (J-ERATO score), which consists of six binary prehospital vital signs. We aimed to evaluate the ability of the score to predict clinical outcomes for hospitalized patients with heat-related illnesses. In a nationwide, prospective, observational study, adult patients hospitalized for heat-related illnesses were registered. A binary logistic regression model and receiver operating characteristic (ROC) curve analysis were used to assess the relationship between the J-ERATO and survival at hospital discharge as a primary outcome. Among eligible patients, 1244 (93.0%) survived to hospital discharge. Multivariable logistic regression analysis revealed that the J-ERATO was an independent predictor for survival to discharge (adjusted odds ratio [OR] 0.47; 95% confidence interval [CI] 0.37–0.59) and occurrence of disseminated intravascular coagulation (DIC) on day 1 (adjusted OR 2.07; 95% CI 1.73–2.49). ROC analyses revealed an optimal J-ERATO cut-off of 5 for prediction of mortality at discharge (area under the curve [AUC] 0.742; 95% CI 0.691–0.787) and DIC development on day 1 (AUC 0.723; 95% CI 0.684–0.758). The J-ERATO obtained before transportation could be helpful in predicting the severity and mortality of hospitalized patients with heat-related illnesses.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-28498-z