• Ling Xing, Shu-Yuan Liu, Han-Ding Mao, Kai-Guo Zhou, Qing Song, and Qiu-Mei Cao.
• Medical School of Chinese PLA, No. 28, Fuxing Road, Beijing 100853, China; Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
• Am J Emerg Med. 2021 Jun 1; 44: 366-372.

ObjectiveTo evaluate the prognostic value of routine coagulation tests for patients with heat stroke.MethodsThis was a multi-center retrospective study. Patients who arrived at the hospital <24 h after the onset of Heat Stroke (HS) were included. The routine coagulation variables were detected within 24 h after the onset, including the lowest platelet count (PLC).Results60-day mortality rate was 20.9%. The median Prothrombin Time-International Normalized Ratio (PT-INR) of the non-surviving patients was significantly higher than that of the survivors (P < 0.01). The median Activated Partial Thromboplastin Time (APTT) in non-surviving patients was significantly higher than in the surviving patients (P < 0.01). A Cox regression analysis revealed that 60-day mortality was associated with PT-INR (P = 0.032) and APTT (P = 0.004). The optimal PT-INR point for predicting 60-day mortality rate was 1.7. The optimal APTT point for predicting 60-day mortality was 51.45. Patients with increased PT-INR (≥1.7) levels had, overall, a significantly reduced survival time (P < 0.01). Patients with elevated APTT (≥51.45) also had a decrease in survival time (P < 0.01). The prognostic scoring, with increased PT-INR (≥1.7) and prolonged APTT (≥51.45) at one point each, was also demonstrated to be useful in predicting 60-day mortality. Patients whose temperature fell to 38.9 °C within 30 min had significantly lower levels of PT-INR and APTT within 24 h than those who took longer to cool down.ConclusionsA prolonged APTT and elevated PT-INR within 24 h are independent prognostic factors of 60-day mortality in HS.Copyright © 2020 Elsevier Inc. All rights reserved.

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