Inpatient burden and mortality of heatstroke in the United States

Int J Clin Pract. 2021 Apr;75(4):e13837. doi: 10.1111/ijcp.13837. Epub 2020 Nov 29.

Abstract

Background: This study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilisation of hospitalisation for heatstroke in the United States. Additionally, this study aimed to explore factors associated with in-hospital mortalities of heatstroke.

Methods: The 2003-2014 National Inpatient Sample database was used to identify hospitalised patients with a principal diagnosis of heatstroke. The inpatient prevalence, clinical characteristics, in-hospital treatments, outcomes, length of hospital stay, and hospitalisation cost were studied. Multivariable logistic regression was performed to identify independent factors associated with in-hospital mortality.

Results: A total of 3372 patients were primarily admitted for heatstroke, accounting for an overall inpatient prevalence of heatstroke amongst hospitalised patients of 36.3 cases per 1 000 000 admissions in the United States with an increasing trend during the study period (P < .001). Age 40-59 was the most prevalent age group. During the hospital stay, 20% required mechanical ventilation, and 2% received renal replacement therapy. Rhabdomyolysis was the most common complication. Renal failure was the most common end-organ failure, followed by neurological, respiratory, metabolic, hematologic, circulatory, and liver systems. The in-hospital mortality rate of heatstroke hospitalisation was 5% with a decreasing trend during the study period (P < .001). The presence of end-organ failure was associated with increased in-hospital mortality, whereas more recent years of hospitalisation was associated with decreased in-hospital mortality. The median length of hospital stay was 2 days. The median hospitalisation cost was $17 372.

Conclusion: The inpatient prevalence of heatstroke in the United States increased, while the in-hospital mortality of heatstroke decreased.

MeSH terms

  • Adult
  • Heat Stroke* / epidemiology
  • Heat Stroke* / therapy
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Inpatients*
  • Length of Stay
  • Middle Aged
  • United States / epidemiology