Report of 182 Cases of Exertional Heatstroke in the French Armed Forces

• Published in: Military medicine Vol. 179; no. 3; pp. 309 - 314
• Main Authors: Abriat, Amandine, Brosset, Christian, Brégigeon, Michel, Sagui, Emmanuel
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2014
• Subjects: Adult; Armed forces; Female; Follow-Up Studies; France - epidemiology; Heat Stroke - epidemiology; Humans; Incidence; Male; Military Personnel - statistics & numerical data; Retrospective Studies; Risk Factors; Young Adult; France
• ISSN: 0026-4075; 1930-613X; 1930-613X
• DOI: 10.7205/MILMED-D-13-00315

Exertional heatstroke (EHS) remains a major problem for the military. The aim of our study was to describe medical history and clinical and biological features of EHS in a large military cohort. We conducted a retrospective study among military subjects admitted to the Military Teaching Hospital Laveran for EHS from 2004 to 2006. Of the 182 subjects, EHS occurred most often at the end (80%) of a timed race of 8 km in battle clothes (84%) between the months of May and October (87%). The subjects were physically fit. Motivation was the primary intrinsic factor reported. A previous episode of EHS was reported by 15.4% of the subjects. Comas or seizures occurred more frequently in subjects whose temperatures exceeded 41°C (p = 0.03). Alanine aminotransferase was consistently increased in subjects who experienced EHS. We observed acute renal failure in 31.3% of the subjects, liver insufficiency in 12%, and disseminated intravascular coagulation in 1%. High creatine kinase levels alone did not correlate with renal failure. Detection of severe EHS in the field before the onset of multiple organ failure is challenging. The determination of the factors contributing to recurrence is urgently needed as EHS remains a life-threatening condition.