Abstract
This study aims to evaluate the risk factors and the association of acute kidney injury with treatments, complications, outcomes, and resource utilization in patients hospitalized for heat stroke in the United States. Hospitalized patients from years 2003 to 2014 with a primary diagnosis of heat stroke were identified in the National Inpatient Sample dataset. End stage kidney disease patients were excluded. The occurrence of acute kidney injury during hospitalization was identified using the hospital diagnosis code. The associations between acute kidney injury and clinical characteristics, in-hospital treatments, outcomes, and resource utilization were assessed using multivariable analyses. A total of 3346 hospital admissions were included in the analysis. Acute kidney injury occurred in 1206 (36%) admissions, of which 49 (1.5%) required dialysis. The risk factors for acute kidney injury included age 20–39 years, African American race, obesity, chronic kidney disease, congestive heart failure, and rhabdomyolysis, whereas age <20 or ≥60 years were associated with lower risk of acute kidney injury. The need for mechanical ventilation and blood transfusion was higher when acute kidney injury occurred. Acute kidney injury was associated with electrolyte and acid-base derangements, sepsis, acute myocardial infarction, ventricular arrhythmia or cardiac arrest, respiratory, circulatory, liver, neurological, hematological failure, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher in acute kidney injury patients. Approximately one third of heat stroke patients developed acute kidney injury during hospitalization. Acute kidney injury was associated with several complications, and higher mortality and resource utilization.
Highlights
The impact of heat stress has become an important issue as the average global temperature has increased
We conducted this study to assess the risk factors and association of acute kidney injury with treatments, complications, outcomes, and resource utilization in patients hospitalized for heat stroke in the United States
Age 20–39 years, African American race, obesity, chronic kidney disease, congestive heart failure, and rhabdomyolysis were associated with increased risk of acute kidney injury
Summary
The impact of heat stress has become an important issue as the average global temperature has increased. Heat stroke is the most severe form of heat-related illness. It is characterized by a core body temperature of more than 40 ◦ C, combined with hot, dry skin and alteration of the central nervous system [1]. The targets of cooling are to reduce the body core temperature to 39 ◦ C within 10–40 min and to 38.5 ◦ C or below within 2 h [5]. Both invasive and noninvasive methods have been used in clinical practice, no prospective study has demonstrated the superiority of either method
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