Jane E. Dematte, Karen O'Mara, Jennifer Buescher, Cynthia G. Whitney, Sean Forsythe, Turi McNamee, Raghavendra B. Adiga, I. Maurice Ndukwu

Annals of Internal Medicine

Published date August 1, 1998

Near-Fatal Heat Stroke during the 1995 Heat Wave in Chicago

  • Provides background stating Chicago sustained a heat wave in July 1995 that resulted in more than 600 excess deaths, 3300 excess emergency department visits, and a substantial number of intensive care unit admissions for near-fatal heat stroke
  • Describes the clinical features of patients admitted to an intensive care unit with near-fatal classic heat stroke
  • Follows 58 patients admitted to the hospital from 12 July to 20 July 1995 who met the case definition of classic heat stroke for 1 year to assess delayed functional outcome and mortality
    • 100 percent of patients experienced multiorgan dysfunction with neurologic impairment
    • 53 percent experienced moderate to severe renal insufficiency
    • 45 percent experienced disseminated intravascular coagulation
    • 10 percent experienced acute respiratory distress syndrome
    • 57 percent had evidence of infection on admission
    • 21 percent died in the hospital
    • Most survivors recovered near-normal renal, hematologic, and respiratory status, but disability persisted, resulting in moderate to severe functional impairment in 33 percent of patients at hospital discharge
    • At 1 year, no patient had improved functional status, and an additional 28 percent of patients had die
  • Results show that: near-fatal classic heat stroke is associated with multiorgan dysfunction; a high percentage of patients had infection at presentation; a high mortality rate was observed during acute hospitalization and at 1 year; substantial functional impairment at discharge persisted 1 year; and the degree of functional disability correlated highly with survival at 1 year