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Wu X, Qian J, He S, Shi X, Chen R, Chen H, Wang L, Wang F, Yang J, Peng N, Tong H. Prediction of in-hospital mortality in patients with exertional heatstroke: a 13-year retrospective study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2451-2462. [PMID: 37694573 DOI: 10.1080/09603123.2023.2253765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
Hyperactivity of coagulation is common in exertional heatstroke (EHS). Disseminated intravascular coagulation (DIC) is the most severe form of coagulation dysfunction and associated with poor outcome. DIC, temperature and Glasgow coma scale score were identified as independent risk factors for in-hospital mortality by multivariate logistic regression analysis, and we developed a nomogram for predicting in-hospital mortality in a 13-year EHS patient cohort. The nomogram was assessed by calibration curves and bootstrap with 1,000 resamples. The receiver operating characteristic curve was constructed, and the area under the curve (AUC) was compared. Two hundred and ten patients were included. The in-hospital mortality was 9.0%, and the incidence of DIC was 17.6%. The AUC of the nomogram was 0.897 (95% CI 0.848-0.935, p < .0001) and was non-inferior to SOFA and APACHE II scores but superior to SIRS score, which were widely-used score systems of disease severity. The nomogram contributed to the adverse outcome prediction of EHS.
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Affiliation(s)
- Xinghui Wu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jing Qian
- Graduate school, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Songbin He
- Department of Intensive Care Unit, Huizhou First People's Hospital, Huizhou, China
| | - Xuezhi Shi
- Department of Intensive Care Unit, General Hospital of Southern Theatre Command of PLA, Guangzhou, China
| | - Ronglin Chen
- Department of Intensive Care Unit, Longgang Central Hospital of Shenzhen, Shenzhen, China
| | - Huaisheng Chen
- Department of Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China
| | - LuLu Wang
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Fanfan Wang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jiale Yang
- Graduate school, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Na Peng
- Department of Emergency Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, China
| | - Huasheng Tong
- Department of Emergency Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, China
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2
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Tang Y, Gu T, Wei D, Yuan D, Liu F. Clinical relevance of neutrophil/lymphocyte ratio combined with APACHEII for prognosis of severe heatstroke. Heliyon 2023; 9:e20346. [PMID: 37767493 PMCID: PMC10520812 DOI: 10.1016/j.heliyon.2023.e20346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
We evaluated clinical implication of neutrophil-lymphocyte ratio (NLR) for severe heatstroke and predictive value of combined acute physiology and chronic health evaluation (APACHEII) score for prognosis of severe heatstroke. Retrospectively, we studied 185 individuals that have been admitted at emergency department for severe heatstroke. On the basis of their prognosis, we sorted the patients into two categories, namely non-survival (n = 43) and survival groups (n = 142). The primary outcome was 30-day mortality. A considerably higher NLR was observed among the non-survivors compared to survivors (P < 0.05). After correction for confounders, statistical analysis using multi-variable Cox regression indicated NLR as an independent risk factor for patient death (HR = 1.167, 95%CI = 1.110-1.226, P < 0.001). Through receiver-operating characteristics (ROC) curve, we estimated area-under the curve (AUC) of NLR to be 0.7720 (95% CI [0.6953, 0.8488]). Also, transformation of NLR into a profile type analysis showed that the marker remained a risk factor for death, which showed trend variation (P for trend <0.001). Subgroup forest plot analysis showed robustness in the predictive ability of NLR after exclusion of confounders. Besides, we demonstrated through Kaplan-Meier (KM) survival analysis curve that high risk NLR mortality substantially exceeded low risk NLR. The combined prediction of NLR and APACHEII achieved higher efficacy than NLR and APACHEII alone (AUC = 0.880, 95% CI [0.8280, 0.9290]). Additionally, Delong test indicated that the combined prediction demonstrated a significantly greater ROC than NLR and APACHEII alone, while DCA showed a considerably higher clinical net benefit rate. Increased NLR is a high risk factor and has predictive value for death in individuals with severe heatstroke. Suggestively, combination of NLR and APACHEII have greater predictive value.
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Affiliation(s)
- Yun Tang
- Department of Critical Care Medicine, Jintan First People's Hospital of Changzhou, Jiangsu, 213200, China
| | - Tijun Gu
- Department of Emergency, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Jiangsu, 213000, China
| | - Dongyue Wei
- Department of Emergency, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Jiangsu, 213000, China
| | - Dong Yuan
- Department of Critical Care Medicine, Jintan First People's Hospital of Changzhou, Jiangsu, 213200, China
| | - Fujing Liu
- Department of Emergency, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Jiangsu, 213000, China
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Sequential organ failure assessment score as a predictor of the outcomes of patients hospitalized for classical or exertional heatstroke. Sci Rep 2022; 12:16373. [PMID: 36180581 PMCID: PMC9525654 DOI: 10.1038/s41598-022-20878-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Heatstroke is a life-threatening event that affects people worldwide. Currently, there are no established tools to predict the outcomes of heatstroke. Although the Sequential Organ Failure Assessment (SOFA) score is a promising tool for judging the severity of critically ill patients. Therefore, in this study, we investigated whether the SOFA score could predict the outcome of patients hospitalized with severe heatstroke, including the classical and exertional types, by using data from a Japanese nationwide multicenter observational registry. We performed retrospective subanalyses of the Japanese Association for Acute Medicine heatstroke registry, 2019. Adults with a SOFA score ≥ 1 hospitalized for heatstroke were analyzed. We analyzed data for 225 patients. Univariate and multivariable analyses showed a significant difference in the SOFA score between non-survivors and survivors in classical and exertional heatstroke cases. The area under the receiver operating characteristic curve were 0.863 (classical) and 0.979 (exertional). The sensitivity and specificity of SOFA scores were 50.0% and 97.5% (classical), 66.7% and 97.5% (exertional), respectively, at a cutoff of 12.5, and 35.0% and 98.8% (classical), 33.3% and 100.0% (exertional), respectively, at a cutoff of 13.5. This study revealed that the SOFA score may predict mortality in patients with heatstroke and might be useful for assessing prognosis.
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Herrero de la Parte B, Rodrigo I, Gutiérrez-Basoa J, Iturrizaga Correcher S, Mar Medina C, Echevarría-Uraga JJ, Garcia JA, Plazaola F, García-Alonso I. Proposal of New Safety Limits for In Vivo Experiments of Magnetic Hyperthermia Antitumor Therapy. Cancers (Basel) 2022; 14:cancers14133084. [PMID: 35804855 PMCID: PMC9265033 DOI: 10.3390/cancers14133084] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Magnetic hyperthermia is a promising therapy for the treatment of certain types of tumors. However, it is not clear what the maximum limit of the magnetic field to which the organism can be subjected without severe and/or irreversible pathophysiological consequences is. This study aims to study the alterations at the physiological level that may occur after exposure to different combinations of frequency and intensity of the applied alternating magnetic field. Understanding the response to alternating magnetic field exposure will allow us to apply this type of antitumor treatment in a safer way for the patient, while achieving an optimal therapeutic result. Abstract Background: Lately, major advances in crucial aspects of magnetic hyperthermia (MH) therapy have been made (nanoparticle synthesis, biosafety, etc.). However, there is one key point still lacking improvement: the magnetic field-frequency product (H × f = 4.85 × 108 Am−1s−1) proposed by Atkinson–Brezovich as a limit for MH therapies. Herein, we analyze both local and systemic physiological effects of overpassing this limit. Methods: Different combinations of field frequency and intensity exceeding the Atkinson–Brezovich limit (591–920 kHz, and 10.3–18 kA/m) have been applied for 21 min to WAG/RijHsd male rats, randomly distributed to groups of 12 animals; half of them were sacrificed after 12 h, and the others 10 days later. Biochemical serum analyses were performed to assess the general, hepatic, renal and/or pancreatic function. Results: MH raised liver temperature to 42.8 ± 0.4 °C. Although in five of the groups the exposure was relatively well tolerated, in the two of highest frequency (928 kHz) and intensity (18 kA/m), more than 50% of the animals died. A striking elevation in liver and systemic markers was observed after 12 h in the surviving animals, independently of the frequency and intensity used. Ten days later, liver markers were almost recovered in all of the animals. However, in those groups exposed to 591 kHz and 16 kA/m, and 700 kHz and 13.7 kA/m systemic markers remained altered. Conclusions: Exceeding the Atkinson–Brezovich limit up to 9.59 × 109 Am−1s−1 seems to be safe, though further research is needed to understand the impact of intensity and/or frequency on physiological conditions following MH.
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Affiliation(s)
- Borja Herrero de la Parte
- Department of Surgery and Radiology and Physical Medicine, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, ES48940 Leioa, Spain;
- Interventional Radiology Research Group, Biocruces Bizkaia Health Research Institute, ES48903 Barakaldo, Spain; (J.J.E.-U.); (J.A.G.); (F.P.)
- Correspondence: (B.H.d.l.P.); (I.R.)
| | - Irati Rodrigo
- Department of Bioengineering, 340 Hearst Memorial Mining Building, University of California, Berkeley, CA 94720, USA
- Department of Electricity and Electronics, Faculty of Science and Technology, University of the Basque Country UPV/EHU, ES48940 Leioa, Spain
- Correspondence: (B.H.d.l.P.); (I.R.)
| | - Jon Gutiérrez-Basoa
- Department of Gastroenterology and Hepatology, General University Hospital Consortium of Valencia, ES46014 Valencia, Spain;
| | - Sira Iturrizaga Correcher
- Department of Clinical Analyses, Galdakao-Usansolo Hospital, ES48960 Galdakao, Spain; (S.I.C.); (C.M.M.)
| | - Carmen Mar Medina
- Department of Clinical Analyses, Galdakao-Usansolo Hospital, ES48960 Galdakao, Spain; (S.I.C.); (C.M.M.)
| | - Jose Javier Echevarría-Uraga
- Interventional Radiology Research Group, Biocruces Bizkaia Health Research Institute, ES48903 Barakaldo, Spain; (J.J.E.-U.); (J.A.G.); (F.P.)
- Department of Radiology, Galdakao-Usansolo Hospital, ES48960 Galdakao, Spain
| | - Jose Angel Garcia
- Interventional Radiology Research Group, Biocruces Bizkaia Health Research Institute, ES48903 Barakaldo, Spain; (J.J.E.-U.); (J.A.G.); (F.P.)
- Department of Physics, Faculty of Science and Technology, University of The Basque Country UPV/EHU, ES48940 Leioa, Spain
| | - Fernando Plazaola
- Interventional Radiology Research Group, Biocruces Bizkaia Health Research Institute, ES48903 Barakaldo, Spain; (J.J.E.-U.); (J.A.G.); (F.P.)
- Department of Electricity and Electronics, Faculty of Science and Technology, University of the Basque Country UPV/EHU, ES48940 Leioa, Spain
| | - Ignacio García-Alonso
- Department of Surgery and Radiology and Physical Medicine, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, ES48940 Leioa, Spain;
- Interventional Radiology Research Group, Biocruces Bizkaia Health Research Institute, ES48903 Barakaldo, Spain; (J.J.E.-U.); (J.A.G.); (F.P.)
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Seah JJ, Wang DY. Pushing the frontiers of military medical excellence: updates, progress and future needs. Mil Med Res 2022; 9:27. [PMID: 35681166 PMCID: PMC9183759 DOI: 10.1186/s40779-022-00388-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/26/2022] [Indexed: 12/25/2022] Open
Abstract
Since its establishment in 2014, Military Medical Research has come a long way in becoming a premier journal for scientific articles from various different specialties, with a special emphasis on topics with military relevance. The field of military medicine may be obscure, and may not be readily encountered by the typical clinician on a day-to-day basis. This journal aims not only to pursue excellence in military research, but also keep current with the latest advancements on general medical topics from each and every specialty. This editorial serves to recap and synthesize the existing progress, updates and future needs of military medical excellence, discussing foremostly the unique traits of literature published in this journal, and subsequently presenting the discourse regarding wartime and peacetime medicine, the role of the military in a public health emergency, as well as wound healing and organ regeneration. Special attention have been devoted to military topics to shed light on the effects of Chemical, Biological, Radiological and Explosive (CBRE) warfare, environmental medicine and military psychiatry, topics which rarely have a chance to be discussed elsewhere. The interconnectedness between military combat and soldier physical and mental well-being is intricate, and has been distorted by pandemics such as coronavirus disease 2019 (COVID-19). This journal has come a long way since its first article was published, steadily contributing to the existing knowledge pool on general medical topics with a military slant. Only with continuous research and sharing, can we build upon the work of the scientific community, with hopes for the betterment of patient care.
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Affiliation(s)
- Jun Jie Seah
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - De-Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Iba T, Connors JM, Levi M, Levy JH. Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management. EClinicalMedicine 2022; 44:101276. [PMID: 35128366 PMCID: PMC8792067 DOI: 10.1016/j.eclinm.2022.101276] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022] Open
Abstract
Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular patterns release, hyperinflammation, and hypercoagulation with suppressed fibrinolysis to produce heatstroke-induced coagulopathy (HSIC). HSIC can progress to disseminated intravascular coagulation and multiorgan failure if severe enough. Platelet count, D-dimer, soluble thrombomodulin, and inflammation biomarkers such as interleukin-6 and histone H3 are promising markers for HSIC. In exertional heatstroke, the measurement of myoglobin is helpful to anticipate renal dysfunction. However, the optimal cutoff for each biomarker has not been determined. Except for initial cooling and hydration, effective therapy continues to be explored, and the use of antiinflammatory and anticoagulant therapies is under investigation. Despite the rapidly increasing risk, our knowledge is limited, and further study is warranted. In this review, we examine current information and what future efforts are needed to better understand and manage HSIC.
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Affiliation(s)
- Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan
- Corresponding author.
| | - Jean Marie Connors
- Hematology Division Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Marcel Levi
- Department of Medicine, University College London Hospitals NHS Foundation Trust, and Cardio-metabolic Programme-NIHR UCLH/UCL BRC London, United Kingdom
| | - Jerrold H. Levy
- Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, United States
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Huang Y, Jiang S, Li W, Fan Y, Leng Y, Gao C. Establishment and Effectiveness Evaluation of a Scoring System-RAAS (RDW, AGE, APACHE II, SOFA) for Sepsis by a Retrospective Analysis. J Inflamm Res 2022; 15:465-474. [PMID: 35082513 PMCID: PMC8786358 DOI: 10.2147/jir.s348490] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/25/2021] [Indexed: 01/19/2023] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Yingying Huang
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Shaowei Jiang
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wenjie Li
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yiwen Fan
- Department of Pathology Medicine Biology, The University Medical Center Groningen, Groningen, the Netherlands
| | - Yuxin Leng
- Critical Care Medicine Department, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Chengjin Gao
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Correspondence: Chengjin Gao; Yuxin Leng Email ;
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Zhong L, Wu M, Ji J, Wang C, Liu Z. Association Between Platelet Levels on Admission and 90-day Mortality in Patients With Exertional Heatstroke, a 10 Years Cohort Study. Front Med (Lausanne) 2021; 8:716058. [PMID: 34858999 PMCID: PMC8632220 DOI: 10.3389/fmed.2021.716058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Heatstroke is a common clinical symptom in summer with high mortality requiring identification of appropriate and rapid methods of assessment. Method: This is a retrospective study that included the recent 10 years clinical data of heatstroke patients. A total of n = 186 patients were included in this study and grouped based on platelet (PLT) abnormality observed on admission. Results: In the study group, n = 120 patients (64.5%) patients had normal PLT and n = 66 patients (35.5%) had abnormal PLT. Compared with PLT-normal group, PLT-abnormal group had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores [median 15.0 (IQR 11.5–21.5) vs. 9.0 (IQR 7.0–12.5)] and SOFA scores [median 6.0 (IQR 4.0–10.0) vs. 2.0 (IQR 2.0–4.0)], lower Sequential Organ Failure Assessment (GCS)[median 8.0 (IQR 5.0–12.0) vs. 13.0 (IQR 9.0–14.0)]. The PLT-abnormal group had severe organ damage, including damage to the coagulation system, liver, and kidney (all p < 0.05). Significant differences were noted in 90-day survival between the two groups even after correction for Age, GCS, White blood cell count (WBC), Neutrophil, International normalized ratio (INR), Activated partial thromboplastin time (APTT), Procalcitonin (PCT), Alanine aminotransferase (ALT), Creatine (CR), D-Dime (D-D) (Before correction P < 0.001; After correction P = 0.009).The area under the ROC curve for the prediction of mortality based on PLT was 80.7% (95% CI 0.726–0.888, P < 0.001), the optimal cutoff value was 94, the sensitivity was 77.3%, and the specificity was 82.6%. Conclusion: Patients with heatstroke with platelet abnormalities during admission have more severe organ impairment and a lower 90-day survival rate even when adjusted for other factors.
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Affiliation(s)
- Li Zhong
- Department of Critical Care Medicine, The First Affiliated Hospital, Guizhou University of Chinese Medicine, Guiyang, China
| | - Ming Wu
- Department of Critical Care Medicine and Infection Prevention and Control, The Second People's Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, China
| | - Jingjing Ji
- Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Conglin Wang
- Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zhifeng Liu
- Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Hirano Y, Kondo Y, Hifumi T, Yokobori S, Kanda J, Shimazaki J, Hayashida K, Moriya T, Yagi M, Takauji S, Yamaguchi J, Okada Y, Okano Y, Kaneko H, Kobayashi T, Fujita M, Yokota H, Okamoto K, Tanaka H, Yaguchi A. Machine learning-based mortality prediction model for heat-related illness. Sci Rep 2021; 11:9501. [PMID: 33947902 PMCID: PMC8096946 DOI: 10.1038/s41598-021-88581-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/07/2021] [Indexed: 11/23/2022] Open
Abstract
In this study, we aimed to develop and validate a machine learning-based mortality prediction model for hospitalized heat-related illness patients. After 2393 hospitalized patients were extracted from a multicentered heat-related illness registry in Japan, subjects were divided into the training set for development (n = 1516, data from 2014, 2017–2019) and the test set (n = 877, data from 2020) for validation. Twenty-four variables including characteristics of patients, vital signs, and laboratory test data at hospital arrival were trained as predictor features for machine learning. The outcome was death during hospital stay. In validation, the developed machine learning models (logistic regression, support vector machine, random forest, XGBoost) demonstrated favorable performance for outcome prediction with significantly increased values of the area under the precision-recall curve (AUPR) of 0.415 [95% confidence interval (CI) 0.336–0.494], 0.395 [CI 0.318–0.472], 0.426 [CI 0.346–0.506], and 0.528 [CI 0.442–0.614], respectively, compared to that of the conventional acute physiology and chronic health evaluation (APACHE)-II score of 0.287 [CI 0.222–0.351] as a reference standard. The area under the receiver operating characteristic curve (AUROC) values were also high over 0.92 in all models, although there were no statistical differences compared to APACHE-II. This is the first demonstration of the potential of machine learning-based mortality prediction models for heat-related illnesses.
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Affiliation(s)
- Yohei Hirano
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Tomioka, 2-1-1, Urayasu, Chiba, 279-0021, Japan.
| | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Tomioka, 2-1-1, Urayasu, Chiba, 279-0021, Japan
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Kanda
- Department of Emergency Medicine, Teikyo University Hospital, Tokyo, Japan
| | - Junya Shimazaki
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School, Suita, Osaka, Japan
| | - Kei Hayashida
- Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masaharu Yagi
- Department of Emergency, Disaster and Critical Care Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shuhei Takauji
- Department of Emergency Medicine, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Junko Yamaguchi
- Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yohei Okada
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Okano
- Department of Emergency Medicine, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Hitoshi Kaneko
- Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Tatsuho Kobayashi
- Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Aizuwakamatsu, Fukushima, Japan
| | - Motoki Fujita
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Ken Okamoto
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Tomioka, 2-1-1, Urayasu, Chiba, 279-0021, Japan
| | - Hiroshi Tanaka
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Tomioka, 2-1-1, Urayasu, Chiba, 279-0021, Japan
| | - Arino Yaguchi
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University, Tokyo, Japan
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10
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Yang MM, Wang L, Zhang Y, Yuan R, Zhao Y, Hu J, Zhou FH, Kang HJ. Correction to: Establishment and effectiveness evaluation of a scoring system for exertional heat stroke by retrospective analysis. Mil Med Res 2021; 8:26. [PMID: 33863384 PMCID: PMC8052645 DOI: 10.1186/s40779-021-00318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Meng-Meng Yang
- Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Lu Wang
- Medical School of Chines, PLA, Beijing, China
| | - Yu Zhang
- Medical School of Chines, PLA, Beijing, China
| | - Rui Yuan
- Medical School of Chines, PLA, Beijing, China
| | - Yan Zhao
- Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jie Hu
- Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Fei-Hu Zhou
- Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hong-Jun Kang
- Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China.
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