Learning Objectives: The objective of this study is to describe the characteristics and outcomes of children hospitalized with a diagnosis of heatstroke during 2012. Methods: A retrospective analysis of the… Click to show full abstract
Learning Objectives: The objective of this study is to describe the characteristics and outcomes of children hospitalized with a diagnosis of heatstroke during 2012. Methods: A retrospective analysis of the Healthcare Cost and Utilization Project 2012 Kids’ Inpatient Database was performed. The database was filtered using the ICD-9 code 99.20 (heat stroke) in all patients between the ages of 1 month-18 years who were discharged during 2012. The demographic variables in children with heat stroke were compared with the rest of the discharges. Sample weighting was employed to produce national estimates. Student t test and Chi square tests were performed using SPSS to analyze the data. Results: Of the total 1,915,874 discharges, 98 were admitted with a diagnosis of heat stroke (prevalence: 0.5 per 10,000 discharges). Median age was higher (12 (IQR 7–15) vs 7 (IQR 1–14) years; p <0.0001) in children with heat stroke. Adolescents comprised 60% of patients admitted with heat stroke diagnosis. Males comprised 72.8 % in heat stroke group (OR:1.78, CI 1.29–2.45). As expected, heat strokes occurred most often in summer (72% (p <0.0001)) of which 31% of heat stroke admissions were in the month of July. Heat stroke seen most commonly in the southern regions followed by western regions (61 % vs 27 %, p <0.0001). Of all children with heat stroke, 33.9% required mechanical ventilation, 9.33% were in renal failure and 4.5 % needed dialysis. Rhabdomyolysis was documented in 39 %, hyperkalemia in 4.9 % and DIC in 14.7 %. Neurological comorbidities were seen in 19.5 % (OR 5.63, CI 3.41–9.30). Documentation of neurological complications include, altered mental status in 34 .8 %, seizures in 8%, and coma in 2.8 %. The mean LOS was about 5 days with 85 % eventually discharged home. The overall mortality rate was 3%. Conclusions: Our study presents a national estimate of discharges with a diagnosis of heat stroke in children. Neurologic comorbidities were common in children with heat stroke. There is a seasonal and regional variation in the prevalence of heat stroke diagnosis. Although heat stroke is uncommon in hospitalized children, it carries a higher mortality and morbidity
               
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