Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012)

• Published in: International journal of environmental research and public health 2018-09, Vol.15 (9), p.1962
• Main Authors: Yamamoto, Takahiro, Fujita, Motoki, Oda, Yasutaka, Todani, Masaki, Hifumi, Toru, Kondo, Yutaka, Shimazaki, Junya, Shiraishi, Shinichiro, Hayashida, Kei, Yokobori, Shoji, Takauji, Shuhei, Wakasugi, Masahiro, Nakamura, Shunsuke, Kanda, Jun, Yagi, Masaharu, Moriya, Takashi, Kawahara, Takashi, Tonouchi, Michihiko, Yokota, Hiroyuki, Miyake, Yasufumi, Shimizu, Keiki, Tsuruta, Ryosuke
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alanine; Alanine transaminase; Blood; Blood tests; Classification; Consciousness; Creatinine; Critical care; Data entry; Emergency medical care; Emergency medical services; Exhaustion; Female; Health care; Heat; Heat Exhaustion - classification; Heat stroke; Heatstroke; Hospitals; Hot Temperature - adverse effects; Humans; Illnesses; Japan; Male; Medical personnel; Medicine; Middle Aged; Observational studies; Patients; Stroke; Syncope; Urea
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph15091962

The Japanese Association for Acute Medicine Committee recently proposed a novel classification system for the severity of heat-related illnesses. The illnesses are simply classified into three stages based on symptoms and management or treatment. Stages I, II, and III broadly correspond to heat cramp and syncope, heat exhaustion, and heat stroke, respectively. Our objective was to examine whether this novel severity classification is useful in the diagnosis by healthcare professionals of patients with severe heat-related illness and organ failure. A nationwide surveillance study of heat-related illnesses was conducted between 1 June and 30 September 2012, at emergency departments in Japan. Among the 2130 patients who attended 102 emergency departments, the severity of their heat-related illness was recorded for 1799 patients, who were included in this study. In the patients with heat cramp and syncope or heat exhaustion (but not heat stroke), the blood test data (alanine aminotransferase, creatinine, blood urea nitrogen, and platelet counts) for those classified as Stage III were significantly higher than those of patients classified as Stage I or II. There were no deaths among the patients classified as Stage I. This novel classification may avoid underestimating the severity of heat-related illness.