Aug 1, 1998

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

by
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
  • 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