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Rationale:
- Classic heatstroke is usually the result of a thermoregulatory imbalance wherein heat dissipation mechanisms are compromised
by underlying illness.
- The heat imbalance in classic heatstroke is typically due to environmental rather than exercise-induced heat gain.
- Elderly individuals are characterized by an intrinsically unstable thermoregulatory system.
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Evidence:
- A meta-analysis conducted to identify individuals at greatest risk of dying during heat waves found that confinement to bed,
not leaving home daily, and being unable to care for onself were associated with the highest risk of death during heat waves
(12).
- In the elderly population, and especially in those with associated diseases, heatstroke is a health threat under severe heat
load (13; 14; 15).
- A review article showed that classic heatstroke is a rare disease in moderate heat load (5).
- In an observational study of 58 patients who had classic heatstroke, a large portion of the patients had infections (16).
- Inefficient thermoregulation, possibly due to decreased heat conductance from core to periphery, contributes to heat intolerance
in former classic heatstroke patients (17).
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Comments:
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Dani Moran, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
James Glazer, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Liran Mendel, BMedSc has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Moshe Rav-Acha, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Heatstroke
> Diagnosis
