Delayed Cerebellar Injury is Affected by Multiple Organ Dysfunction Syndrome Caused by Heat Stroke, a Retrospective Cohort Study

Abstract Objective Nervous dysfunction is the main manifestation of heat stroke (HS). Here we investigated the clinical signs for HS-induced nerve injuries. Methods Retrospective data were collected on 119 patients who got HS from 2016 to 2020. Patients were divided into 4 groups, including the cerebellar injury group, the other nerve injuries group, non-cerebellar injury group and non-nerve injury group. The age, body temperature (Tc), degree of consciousness disorder, liver and kidney function, blood coagulation function, blood routine and cardiac indicators within 24 h after HS were summarized. Moreover, we performed regression analyses to identify risk factors for nervous dysfunction. The Activity of Daily Living (ADL) score was assessed 3 months after HS to evaluate the prognosis of HS. Results Compared with other groups, the cerebellar injury group had shorter Tc recovering time, lower GSC scales, longer coma time and more hypotension, gastrointestinal bleeding, multiple organ dysfunction syndrome (MODS) and metabolic acidosis significantly. The cerebellar injury group had higher myocardial enzymogram and indexes of liver and kidney dysfunction, immune and coagulation dysfunction significantly. Risk factors associated with HS-induced cerebellar injury are Tc, recovery time of Tc, NSE, GCS scale, lymphocyte count, HLA-DR/CD14, coagulation dysfunction, cardiac injury, metabolic acidosis and MODS. The ADL scale of the cerebellar injury group and the other nerve injury group were significantly lower than other groups. Conclusions Patients with severe coma and MODS are more prone to cerebellar injury after HS and the HS-induced nerve injury leaded to a worse prognosis.