Correlation of Lactate Dehydrogenase Levels with Arrhythmia in Classic Severe Heatstroke

Objective The incidence and risk factors of arrhythmia in patients with classic severe heatstroke remain unclear. This study aimed to investigate the association between lactate dehydrogenase (LDH) levels and arrhythmia in such patients. Methods A retrospective multicenter cohort study was conducted involving patients with classic severe heatstroke across six hospitals. LDH levels were transformed with natural Logarithm, and binary logistic regression was employed to analyze the association between Ln(LDH) and arrhythmia. Receiver operating characteristic (ROC) curve determined LDH’s predictive value, with the area under the curve (AUC) reflecting accuracy. Mediation analysis assessed whether LDH mediated the relationship between temperature and arrhythmia. Results Of 261 eligible patients, 80 developed arrhythmia during hospitalization (30.7%). After adjusting for confounders, logistic regression demonstrated that higher Ln(LDH) was significantly associated with arrhythmia ((odds ratio [OR] = 2.871, 95% confidence interval [CI]: 1.165–7.075). ROC analysis exhibited favorable predictive performance (AUC = 0.7208; 95% CI: 0.6567–0.7850). Mediation analysis indicated that LDH partially mediated the association between temperature and arrhythmia, accounting for 30.5% (95% CI: 15.1%–62.0%). Conclusion Elevated LDH is significantly associated with increased arrhythmia risk in classic severe heatstroke and shows strong predictive potential.