Evidence map›Paper›PMID 38153655›Full record

ReviewCJEM2024

Heatstroke presentations to urban hospitals during BC's extreme heat event: lessons for the future.

Kira Gossack-Keenan, David Seonguk Yeom, Josephine Kanu, Jeffrey P Hau, Rhonda J Rosychuk, Dylan Clark, Rajan Bola, Caris Tze, Chris Niosco, Hayley Emery and 2 more

Abstract readReview
In one paragraph

Review in CJEM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kira Gossack-KeenanDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada. kira.gossackkeenan@vch.ca.ORCID 0000-0002-7631-1652
David Seonguk YeomDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Josephine KanuDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Jeffrey P HauDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Rhonda J RosychukDepartment of Pediatrics, University of Alberta, Edmonton, Canada.
Dylan ClarkClimate Institute Canada, Vancouver, BC, Canada.
Rajan BolaDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Caris TzeDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Chris NioscoDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Hayley EmeryDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Phillip YeungDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Corinne M HohlDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClimate change is leading to more extreme heat events in temperate climates that typically have low levels of preparedness. Our objective was to describe the characteristics, treatments, and outcomes of adults presenting to hospitals with heatstroke during BC's 2021 heat dome.

methodsWe conducted a review of consecutive adults presenting to 7 hospitals in BC's Lower Mainland. We screened the triage records of all patients presenting between June 25th and 30th, 2021 for complaints related to heat, and reviewed the full records of those who met heatstroke criteria. Our primary outcome was in-hospital mortality. We used Mann-Whitney U tests and logistic regression to investigate associations between patient and treatment factors and mortality.

resultsAmong 10,247 consecutive presentations to urban hospitals during the extreme heat event, 1.3% (139; 95% confidence intervals [CI] 1.1-1.6%) met criteria for heatstroke. Of heatstroke patients, 129 (90.6%) were triaged into the two highest acuity levels. Patients with heatstroke had a median age of 84.4 years, with 122 (87.8%) living alone, and 101 (84.2%) unable to activate 911 themselves. A minority (< 5, < 3.6%) of patients presented within 48 h of the onset of extreme heat. Most patients (107, 77.0%) required admission, and 11.5% (16) died in hospital. Hypotension on presentation was associated with mortality (odds ratio [OR] 5.3).

interpretationHeatstroke patients were unable to activate 911 themselves, and most presented with a 48-h delay. This delay may represent a critical window of opportunity for pre-hospital and hospital systems to prepare for the influx of high-acuity resource-intensive patients.

Indexed as

Extreme HeatHeat StrokeAdultAged, 80 and overHospitalizationHospitals, UrbanHot TemperatureHumansClimateEmergency departmentEmergency medicineHeastrokeHeatwave

Identifiers

PMID38153655
PMCPMC10861625

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.