Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012)

Takahiro Yamamoto, Motoki Fujita, Yasutaka Oda, Masaki Todani, Toru Hifumi, Yutaka Kondo, Junya Shimazaki, Shinichiro Shiraishi, Kei Hayashida, Shoji Yokobori, Shuhei Takauji, Masahiro Wakasugi, Shunsuke Nakamura, Jun Kanda, Masaharu Yagi, Takashi Moriya, Takashi Kawahara, Michihiko Tonouchi, Hiroyuki Yokota, Yasufumi Miyake, Keiki Shimizu and Ryosuke Tsuruta
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Takahiro Yamamoto: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
Motoki Fujita: Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
Yasutaka Oda: Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
Masaki Todani: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
Toru Hifumi: Emergency and Critical Care medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
Yutaka Kondo: Department of Emergency Medicine and Critical Care Medicine, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
Junya Shimazaki: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
Shinichiro Shiraishi: Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, 1-1 Tsuruga-machi, Aizuwakamatsu, Fukushima 965-8611, Japan
Kei Hayashida: Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
Shoji Yokobori: Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Shuhei Takauji: Department of Emergency Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan
Masahiro Wakasugi: Emergency and Critical Care Center, Toyama University Hospital, 2630, Sugitani, Toyama City, Toyama 930-0152, Japan
Shunsuke Nakamura: Department of Emergency Medicine, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama City, Wakayama 640-8505, Japan
Jun Kanda: Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan
Masaharu Yagi: Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1 Iso, Urasoe, Okinawa 901-2132, Japan
Takashi Moriya: Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama City, Saitama 330-8503, Japan
Takashi Kawahara: Japan Sport Council, 2-8-35 Kita-Aoyama, Minato-ku, Tokyo 107-0061, Japan
Michihiko Tonouchi: Japan Meteorological Business Support Center, To-nen Bld, 3-17 Kanda-Nishikicho, Chiyoda-ku, Tokyo 101-0054, Japan
Hiroyuki Yokota: Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Yasufumi Miyake: Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan
Keiki Shimizu: Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan
Ryosuke Tsuruta: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan

IJERPH, 2018, vol. 15, issue 9, 1-17

Abstract: The Japanese Association for Acute Medicine Committee recently proposed a novel classification system for the severity of heat-related illnesses. The illnesses are simply classified into three stages based on symptoms and management or treatment. Stages I, II, and III broadly correspond to heat cramp and syncope, heat exhaustion, and heat stroke, respectively. Our objective was to examine whether this novel severity classification is useful in the diagnosis by healthcare professionals of patients with severe heat-related illness and organ failure. A nationwide surveillance study of heat-related illnesses was conducted between 1 June and 30 September 2012, at emergency departments in Japan. Among the 2130 patients who attended 102 emergency departments, the severity of their heat-related illness was recorded for 1799 patients, who were included in this study. In the patients with heat cramp and syncope or heat exhaustion (but not heat stroke), the blood test data (alanine aminotransferase, creatinine, blood urea nitrogen, and platelet counts) for those classified as Stage III were significantly higher than those of patients classified as Stage I or II. There were no deaths among the patients classified as Stage I. This novel classification may avoid underestimating the severity of heat-related illness.

Keywords: heat-related illness; international classification; heat cramp; syncope; heat exhaustion; heat stroke; novel classification (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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