Computed tomographic findings in heat stroke patients: A retrospective review at Phramongkutklao Hospital between 2002-2017
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Abstract
Introduction: Incidences of heat stoke are increasing over time. Early diagnosis and prompt management are crucial for the survival of patients. Magnetic resonance imaging could help in diagnosis and prognosis. However, due to limited resources and unstable status of patients, Computed Tomography (CT scan) may be used for evaluation instead.
Purpose: To study various findings of the computed tomography in heatstroke patients and the percentage of occurrences at Phramongkutklao Hospital.
Material and methods: This research was conducted as a retrospective descriptive study. The computed tomography of heatstroke patients (ICD-10 = T67.0) performed during 2002-2017 was retrospectively reviewed. The data was collected through the picture archiving and communicating system (PACS) and medical records at Phramongkutklao Hospital.
Result: A total of 128 patients were diagnosed with heatstroke between January 1, 2002 and December 31, 2017. Only 19 patients were examined by CT scan. The mortality rate of this group was 10.5%. Six of 19 had abnormality found on the CT scan, however, it was not correlated with the treatment outcome. The neurological deficits found among 80% of the survivors with partial recovery were cerebellar ataxia. The level of consciousness as shown in GCS did not seem to correlate with the treatment outcome either.
Conclusion: Most neurological deficits of the survivors occurred at cerebellum. The CT scan was not sensitive enough to detect abnormality and show correlation with the treatment outcome. In the future, we should use MRI scan instead of CT scan even for patients with low Glasgow coma score because of high sensitivity of MRI to detect abnormality of cerebellum.
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