Study, meta-analysis examine factors associated with death from ...( Individuals who live in a nursing ho...),Health

Individuals who live in a nursing home or take medication to lower blood pressure appear more likely to die during or following hospitalization for heatstroke, according to a study posted online today that will appear in a later print issue of Archives of Internal Medicine, one of the JAMA/Archives journals. A meta-analysis of previous studies also published online today found that being confined to bed, not leaving home daily or being unable to care for oneself also are associated with death from heatstroke.

A severe heat wave struck Europe in 2003, with death toll estimates ranging from 22,000 to more than 70,000, according to background information in the articles. France alone had 14,800 deaths in a nine-day period, one-third of which were caused by heatstroke. Heatstroke is the most severe heat-related illness and is defined by an elevated core body temperature above 40 degrees Celsius [104 degrees Fahrenheit], associated with central nervous system abnormalities, the authors write. Unlike exertional heatstroke, which occurs during strenuous exercise, classic heatstroke results directly from exposure to high temperatures. During heat waves, most victims are found dead at home, and 60 percent of those who reach the hospital are likely to die.

Laurent Argaud, M.D., Ph.D., of Hospices Civils de Lyon and University Claude Bernard Lyon I, and colleagues evaluated survival rates and long-term outcomes of 83 patients hospitalized for heatstroke in Lyon, France, during the summer of 2003. Demographic, medical and functional data were collected when individuals entered the hospital, and they were assessed again after 28 days and one and two years.

Fifty-eight percent of patients died within 28 days. Patients who died:

• more often came from an institution for the elderly (24 of 48 non-survivors vs. seven of 35 survivors)

• were more likely to have used antihypertensive medications long-term (33 of 48 who died vs
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