Key result
Acute MI during heat stroke hospitalization is linked to ~5-fold higher in-hospital mortality.
Why the study?
This study aimed to assess the risk factors and impact of acute myocardial infarction on in-hospital treatments, complications, outcomes, and resource utilization in patients hospitalized for heat stroke in the United States.
Does the occurrence of acute myocardial infarction worsen in-hospital mortality, complications, and resource utilization in patients hospitalized for heat stroke?
Observational (n=3,372)
Yes
Does the occurrence of acute myocardial infarction worsen in-hospital mortality, complications, and resource utilization in patients hospitalized for heat stroke?
Effect estimate: OR 5.2
Acute myocardial infarction complicates 7% of heat stroke hospitalizations and is associated with a 5.2-fold increase in the odds of in-hospital mortality, alongside higher rates of organ failure and resource utilization.
May support cardiac monitoring in heat stroke; leaves open whether AMI treatment modifies outcomes.
BACKGROUND: This study aimed to assess the risk factors and impact of acute myocardial infarction on in-hospital treatments, complications, outcomes, and resource utilization in hospitalized patients for heat stroke in the United States. METHODS: Hospitalized patients with a principal diagnosis of heat stroke were identified in the National Inpatient Sample dataset from the years 2003 to 2014. Acute myocardial infarction was identified using the hospital International Classification of Diseases, Ninth Revision (ICD-9), diagnosis of 410.xx. Clinical characteristics, in-hospital treatment, complications, outcomes, and resource utilization between patients with and without acute myocardial infarction were compared. RESULTS: A total of 3372 heat stroke patients were included in the analysis. Of these, acute myocardial infarction occurred in 225 (7%) admissions. Acute myocardial infarction occurred more commonly in obese female patients with a history of chronic kidney disease, but less often in male patients aged <20 years with a history of hypothyroidism. The need for mechanical ventilation, blood transfusion, and renal replacement therapy were higher in patients with acute myocardial infarction. Acute myocardial infarction was associated with rhabdomyolysis, metabolic acidosis, sepsis, gastrointestinal bleeding, ventricular arrhythmia or cardiac arrest, renal failure, respiratory failure, circulatory failure, liver failure, neurological failure, and hematologic failure. Patients with acute myocardial infarction had 5.2-times greater odds of in-hospital mortality than those without myocardial infarction. The length of hospital stay and hospitalization cost were also higher when an acute myocardial infarction occurred while hospitalized. CONCLUSION: Acute myocardial infarction was associated with worse outcomes and higher economic burden among patients hospitalized for heat stroke. Obesity and chronic kidney disease were associated with increased risk of acute myocardial infarction, while young male patients and hypothyroidism were associated with decreased risk.
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Bathini et al. (2020) conducted an observational in Heat stroke (n=3,372). Acute myocardial infarction vs. No acute myocardial infarction was evaluated on In-hospital mortality (OR 5.2). Acute myocardial infarction during hospitalization for heat stroke was associated with 5.2-times greater odds of in-hospital mortality compared to patients without myocardial infarction.
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