Clinical characteristics of cases of acute deterioration in early exertional heat illness: Association with altered consciousness, tachycardia, and elevated serum creatinine levels

Abstract

We investigated the clinical characteristics of cases of acute deterioration in early exertional heat illness (EHI). We examined the medical records of 2,619 cases of trainees of police officer enrolled in the Hyogo Prefectural Police Academy who were treated for early EHI from April 2012 to September 2024, divided into an acute deterioration group (group D, 16 cases) and a recovery group (group R, 2,603 cases). Compared to group R, group D showed significantly higher frequency of altered consciousness and significantly faster pulse rate at the time of examination (130 [116-143] bpm vs. 141 [130-152] bpm, p=0.033), a tendency for serum creatinine (Cr) value to be higher, and cases with high serum Cr values were more frequent (26.0% vs. 55.6%, p=0.058). In group D, the high serum Cr value group showed a significantly faster pulse rate than the non-high serum Cr value group (125 [114-132] bpm vs. 150 [145-167] bpm, p=0.032). These results suggest that acute deterioration in EHI may be associated with altered consciousness, tachycardia, and elevated serum Cr value.