Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 12 / 09 / 2021

Articles

Abstract

ORIGINAL ARTICLE

Characteristics and Outcome of Exertional Heatstroke Patients Complicated by Acute Hepatic Injury: A Cohort Study

Jingjing Ji1,#, Jinghua Gao1,#, Conglin Wang1, Leifang Ouyang1, Zheying Liu1 and Zhifeng Liu1,2,*

1  Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, Guangdong, China
2  Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA, General Hospital of Southern Theater Command of PLA, Guangzhou, Guangdong, China
#These authors contributed equally to this study.
*Correspondence to:Zhifeng Liu, Department of Critical Care Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, Guangdong 510010, China. ORCID:https://orcid.org/0000-0001-6273-1667 . Tel: +86-20-3665-3483, Fax: +86-20-3665-5909, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(5):655-660 DOI: 10.14218/JCTH.2021.00084
Received:March 7, 2021 Accepted:June 1, 2021 Published online:June 22, 2021

Abstract

Background and Aims:Exertional heatstroke (EHS) is associated with strenuous physical activity in hot environments. The present study aimed to investigate dynamic changes of hepatic function indices in EHS patients and determine risk factors for death.

Methods:This single-center retrospective cohort study considered all patients with EHS admitted to the intensive care unit at the General Hospital of Southern Theater Command of PLA from October 2008 to May 2019. Data on general characteristics, organ function parameters, and the 90-day outcome of enrolled patients were collected. Hepatic indices were collected dynamically, and patients with acute hepatic injury (AHI) were identified by plasma total bilirubin (TBIL) ≥34.2 µmol/L and an international normalized ratio ≥1.5, or with any grade of hepatic encephalopathy.

Results:In patients who survived, TBIL, alanine aminotransferase and aspartate aminotransferase were increased at 24 h, peaked at 2–3 days, and began to decrease at 5 days. In non-survivors, TBIL continuously increased post-admission. The area under the receiver operating characteristic curve for the prediction of mortality based on sequential organ failure assessment (SOFA) scores was 89.8%, and the optimal cutoff value was 7.5. Myocardial injury and infection were identified as independent risk factors for death in EHS patients with AHI.

Conclusions:In EHS patients, hepatic dysfunction usually occurred within 24 h. Patients with AHI had more severe clinical conditions, and significantly increased 90-day mortality rates. SOFA scores over 7.5, complicated with myocardial injury or infection, were found to be risk factors for death in EHS patients with AHI.

Keywords

Exertional heatstroke, Acute hepatic injury, Mortality, TBIL, SOFA

Journal of Clinical and Translational Hepatology 2021 vol. 9, 655-660  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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