Study, meta-analysis examine factors associated with death from ...(. 13 of 35 survivors) had a higher...),Health

• had a higher average body temperature on hospital admission (41.3 degrees Celsius/106.3 degrees Fahrenheit compared with 40.7 degrees Celsius/105.3 degrees Fahrenheit)

• had more respiratory, cardiovascular or kidney dysfunctions than survivors

• were more likely to come to the hospital in a coma (39 or 81 percent of non-survivors vs. eight or 23 percent of survivors) or to have anuria, the inability to form urine (19 vs. zero)

A total of 27 patients (33 percent) were alive after one year and 24 (29 percent) were alive after two years. Functional outcome at one year revealed that six patients (22 percent), who lived at home before the heat wave, required care in institutions for elderly patients because of severe functional limitations, the authors write. Similarly, a dramatic alteration in functional status was recorded in most surviving patients.

Heatstroke is associated with poor outcomes in temperate urban areas, the authors conclude. This could be explained at least in part by our lack of experience. Western temperate countries need to be more prepared for future heat waves.

In the meta-analysis, Abderrezak Bouchama, M.D., of the King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, and colleagues identified six studies published through 2006 that included 1,065 heat waverelated deaths. All of the studies selected compared risk factors between those who died during heat waves and a control group of those who did not.

Being confined to bed, not leaving home daily and being unable to care for oneself were associated with the highest risk of death during heat waves, the authors write. Pre-existing psychiatric illness tripled the risk of death, followed by cardiovascular and pulmonary illness. Working home air-conditioning, visiting cool environments and increasing social contact were strongly associated with better outcomes. Taking
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