ArticleRenal failure2025
Development and validation of the predictive scoring system for 90-day mortality in critical ill patients with exertional heatstroke.
Article in Renal failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDespite rising incidence, exertional heatstroke (EHS) lacks validated prognostic scoring tools. This study aimed to developed and validated a 90-day prognostic model for EHS patients.
methodsWe conducted a retrospective cohort study of patients with EHS. Logistic regression analysis was utilized to identify the risk predictors associated with 90-day mortality. Using the mathematical transformation principle, the regression coefficients of each risk predictor were reassigned to develop a practical predictive scoring system. In this study, the predictive capability of the scoring model was validated
resultsAmong 273 EHS patients in this cohort, 24 (8.8%) experienced 90-day mortality. Logistic regression analysis revealed acute kidney injury (AKI), prolonged activated partial thromboplastin time (APTT), and low fibrinogen as independent risk predictors. A scoring system (0-5 points) was developed by reassigning each predictor according to the logistic regression coefficient: AKI 3 points, prolonged APTT (≥47 s) 1 point, and fibrinogen (<2 g/L) 1 point. Internal validation using 1000 bootstrapping samples demonstrated that the scoring system had a relatively high discriminative ability, with a C-index of 0.90 (95% CI: 0.90-0.93). Using receiver operating characteristic curve analysis, the composite index incorporating these three risk predictors demonstrated a sensitivity of 78.3% and specificity of 89.9% in predicting 90-day mortality (area under the curve: 0.90; 95% confidence interval (CI): 0.81-0.98;
conclusionsA predictive scoring system based on AKI, APTT, and fibrinogen can help predict the risk of 90-day mortality in patients with EHS.
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