An insight into the heatstroke in Northern India: Clinico-pathological observation and outcomes from a tertiary care center

Abstract

Objectives To observe the clinical presentation, pathological changes, and outcomes of heatstroke at a tertiary care center. Material and Methods Patients presented with an axillary temperature above 104°F to the casualty during summers in the months of April and May 2022 were screened. After excluding the other causes of fever and based on history, patients were diagnosed as suffering from heatstroke. After taking valid consent, treatment was initiated, and all observations were taken. Clinical presentation, demographic data, vitals, and investigations (hemogram, renal function, liver function, CPK, IL6, CRP, and random glucose levels) were recorded, diagnosed, and enrolled for observation. Chi-Square test for 2 x 2 contingency table used to identify the association between CPK and muscle cramps. The T-test for 2 Independent Means and the Pearson Correlation Coefficient test were used for analyzing other data. Results For the study, 112 patients were enrolled and classified as per severity: 80 were pre heatstroke, 22 were mild heatstroke, and 10 were severe heatstroke. Age above 50 years is associated with severe forms of disease and poor outcomes. Out of 112, 28 (25%) participants were 50 years or above age. Nine (32.1%) out of these 28 developed pre-heatstroke, and 19 (67.8%) developed mild to severe heatstroke. Creatinine kinase was raised in 17 out of 112 (15.1%) participants, but the proportion of participants having raised CPK does not differ by the presence of myalgia. IL6 was also found to be elevated and related directly to the severity of the disease in this study. Conclusion Heatstroke is a common disease that occurs due to working on farms during the summer. Old age is more prone to severe disease and poor outcomes. Raised IL6 also correlates directly with disease severity.