Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study.

PURPOSE: Severe heatstroke is often complicated by disseminated intravascular coagulation (DIC). The aim of this study was to evaluate platelet function assessed through thromboelastography (TEG) at the emergency department (ED) and DIC severity among patients with heatstroke.

MATERIALS AND

METHODS

We performed a retrospective single-tertiary hospital cohort study. Patients admitted to an intensive care unit (ICU) with heatstroke were enrolled. Platelet function was evaluated as the difference between citrated functional fibrinogen-maximum amplitude (CFF-MA) and citrated rapid TEG-maximum amplitude (CRT-MA) at the ED. DIC was defined as a score ≥ 4 points based on the Japanese Association of Acute Medicine score.

RESULTS

A total of 31 patients with heatstroke were enrolled. The median platelet count was 18.1 × 104/μL, (interquartile range [IQR]: 12.6-25.0 × 104/μL), and the median platelet function evaluated as CFF-MA-CRT-MA was 34.4 mm (IQR: 27.8-37.8 mm). Among several clinical and TEG-related parameters, the platelet function was strongly correlated with the DIC score (R = -0.63, p < 0.001) and significantly associated with DIC development (area under the receiver operating characteristic curve 0.87 [95 % confidence interval: 0.72-0.99]).

CONCLUSIONS

These results suggested that platelet dysfunction occurs in heatstroke-induced DIC, indicating that platelet function evaluation by TEG can provide complementary information and enhance our understanding about the subtypes of heatstroke.