Risk factors and predictive models for sequelae of heat stroke primarily involving cerebellar dysfunction

Autor: Xiao-Xiao Ni, Gai-Ci Xue, Ye-Qun Guo, Xiao-Juan Xie, Jie Wang, Zhi-Feng Liu
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Critical Public Health, Vol 34, Iss 1, Pp 1-14 (2024)
Druh dokumentu: article
ISSN: 09581596
1469-3682
0958-1596
DOI: 10.1080/09581596.2024.2336581
Popis: The occurrence of sequelae is common after heatstroke. There is a lack of risk prediction data regarding the prevalence of sequelae. This study aims to develop a predictive model for the sequelae after heatstroke, including cerebellar dysfunction. Heatstroke patients admitted to our hospital in the past 8 years were retrospectively enrolled. Regression analyses were conducted to identify risk factors associated with sequelae and cerebellar dysfunction. A prediction model for post-heatstroke sequelae was developed and internally and externally validated. Twenty-three percent of the patients experienced sequelae, with cerebellar dysfunction accounting for 51.7%. Patients with sequelae had longer duration of hyperthermia and coma, lower Glasgow Coma Scales scores, elevated core temperature, increased incidence of multiple organ dysfunction upon admission, and a worse prognosis compared to non-sequelae patients. Patients with cerebellar injury exhibited impaired balance, and a Sepsis-related Organ Failure Assessment (SOFA) score > 5 is an independent risk factor. The prediction system included advanced age, coma, and an APACHE-II score > 10 upon admission, predicting sensitivity = 0.8966, specificity = 0.8925, and AUC of ROC curve = 0.941 (95% CI: 0.884 ~ 0.976). The C-index in the internal verification was 0.942 (95% CI: 0.847 ~ 0.981) and the AUC in the external verification was 0.816 (95% CI: 0.699 ~ 0.902). The prediction system included advanced age, coma, and higher APACHE-II scores as variables, indicating a significant prevalence of sequelae. Higher SOFA scores were associated with the increased occurrence of cerebellar dysfunction and balance impairment. The prediction system could better predict sequelae after heatstroke.
Databáze: Directory of Open Access Journals
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