Lyon, France -- Residence in a nursing home and taking antihypertensive medications are among the factors that increase the risk of death following heatstroke, investigators here found.
LYON, France, Aug. 13 -- Residence in a nursing home and taking antihypertensive medications are among the factors that increase the risk of death following heatstroke, investigators here found.
Among 83 patients admitted for heatstroke, 58% died within 28 days and 71% died within two years, reported Laurent Argaud, M.D., Ph.D., of Hospices Civils de Lyon and University Claude Bernard Lyon I, in the Aug. 13 issue of Archives of Internal Medicine.
Half of the 48 patients who died within 28 days of hospital admission came from a nursing home or retirement home, compared with just seven of the 35 patients who were still alive two years after developing heatstroke (P=0.005), Dr. Argaud and colleagues found.
And 33 of the 48 were on antihypertensive therapy, compared with 13 of the 35 survivors (P=0.004). Patients who died were also more likely to be taking phenothiazines.
In a six-study meta-analysis published in the same issue, being confined to bed (OR, 6.44; 95% CI, 4.5-9-2), not leaving home on a daily basis (OR 3.35; 95% CI, 1.6-6.9), and not being able to take care of oneself (OR 2.97; 95% CI, 1.8-4.8) were all associated with a heightened risk of death after heatstroke.
What's more, pre-existing psychiatric illness tripled the risk of death following a heat wave, followed by cardiovascular disease (OR 2.48; 95% CL 1.3-4.8) and pulmonary disease (OR 1.61; 95% CI 1.2-2.1), reported Abderrezak Bouchama, M.D., of the King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia.
The first study evaluated risks among patients treated for heatstroke at an inner city university hospital during the European heat wave of August 2003.
Patients who presented to the hospital with a fever of 41 degrees C or higher and/or had respiratory, cardiovascular or kidney dysfunction had greater risk of mortality early on, the researchers found.
Being in a coma at admission also increased mortality risk. Specifically, 81% of patients who died presented in a coma compared with 23% of the survivors (P=