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Int. J. Environ. Res. Public Health 2018, 15(9), 1962; https://doi.org/10.3390/ijerph15091962

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

1
Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
2
Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
3
Emergency and Critical Care medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
4
Department of Emergency Medicine and Critical Care Medicine, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
5
Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
6
Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, 1-1 Tsuruga-machi, Aizuwakamatsu, Fukushima 965-8611, Japan
7
Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
8
Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
9
Department of Emergency Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan
10
Emergency and Critical Care Center, Toyama University Hospital, 2630, Sugitani, Toyama City, Toyama 930-0152, Japan
11
Department of Emergency Medicine, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama City, Wakayama 640-8505, Japan
12
Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan
13
Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1 Iso, Urasoe, Okinawa 901-2132, Japan
14
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
15
Japan Sport Council, 2-8-35 Kita-Aoyama, Minato-ku, Tokyo 107-0061, Japan
16
Japan Meteorological Business Support Center, To-nen Bld, 3-17 Kanda-Nishikicho, Chiyoda-ku, Tokyo 101-0054, Japan
17
Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan
Authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 2 August 2018 / Revised: 6 September 2018 / Accepted: 6 September 2018 / Published: 8 September 2018
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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. View Full-Text
Keywords: heat-related illness; international classification; heat cramp; syncope; heat exhaustion; heat stroke; novel classification heat-related illness; international classification; heat cramp; syncope; heat exhaustion; heat stroke; novel classification
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Yamamoto, T.; Fujita, M.; Oda, Y.; Todani, M.; Hifumi, T.; Kondo, Y.; Shimazaki, J.; Shiraishi, S.; Hayashida, K.; Yokobori, S.; Takauji, S.; Wakasugi, M.; Nakamura, S.; Kanda, J.; Yagi, M.; Moriya, T.; Kawahara, T.; Tonouchi, M.; Yokota, H.; Miyake, Y.; Shimizu, K.; Tsuruta, R. Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012). Int. J. Environ. Res. Public Health 2018, 15, 1962.

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