Outcome of heat stroke patients referred to a tertiary hospital in Pakistan: a retrospective study.

Abstract

Climate change has heightened the threat of heat stroke in previously temperate zones. This study aimed to assess the outcome of patients in relation to mortality and the role of effect modifiers among heatstroke patients presenting to a tertiary care hospital in Karachi during June 2015. A retrospective observational study was conducted on heatstroke patients 20-27 June 2015 at the Emergency Room(ER) of a private hospital in Karachi, Pakistan. Patients' demographic data, disease severity, presentation and outcomes were determined. Statistical data was reported as numbers, percentages and mean ± SD. In total, 315 patients reported to ER; 76.6% patients survived, 23% expired. Males were 55% and 60% patients were fully mobile. Hypertension was the most frequent concurrent disorder. Fever documented in 79.4% and CNS derangement in 73.3% patients were the top most presenting features. Fever and disease severity were found to exert significant impact on disease outcome. Mortality rate dropped from 26 June onwards from 24.35% to 15.9% by using evaporative cooling technique combined with air conduction and maintaining room temperature at 22-24°C. Poor outcome during heatstroke can be minimized by advance planning and timely intervention in lowand middle-income countries.