Objective: To explore the related factors of death from severe heat stroke in Shanghai from 2013 to 2017. Methods: The data of 1 152 patients with severe heat stroke who were divided into survival (n=1 037) and death (n=115) groups including gender, age and heat stroke type (heat cramp, heat exhaustion, heat apoplexy and the mixed type) were collected from meteorological bureau and case report system for high temperature heat stroke in Shanghai from 2013 to 2017. Meanwhile, the meteorological data of the onset date of severe heat stroke cases were collected, including maximum temperature, minimum temperature, daily temperature, relative humidity, air pressure, precipitation and wind speed. The differences of individual and meteorological factors between the two groups were compared, and multivariate logistic regression model was used to analyze the related factors of death from severe heat stroke. Results: Among 1 152 cases, the mean±SD of age was (56.29±18.95) years old, 843 (73.18%)were male, 962 (83.51%) were in the heat wave period; 322 cases (27.95%) were heat cramp, 170 cases (14.76%) were heat exhaustion, 533 cases (46.27%) were heat apoplexy and 114 cases (9.90%) were the mixed type. Daily average temperature ((32.81±1.99) ℃), daily maximum and minimum temperatures ((38.20±2.24) ℃ and (29.22±1.94) ℃) in survival group were lower than those in death group (all P values<0.001), which were (33.76±1.17) ℃, (39.19±1.31) ℃ and (29.72±1.66) ℃. Daily average relative humidity ((60.36±9.75)%) and daily minimum relative humidity ((41.26±9.71)%) in survival group were higher than those in death group(allP values <0.05), which were (54.59±6.89)% and (35.60±7.24)%. The results of logistic regression analysis suggested that compared with the cases with daily average humidity <60% and a mixed type heat stroke, the death OR (95%CI) values of cases with daily average humidity >60%, heat cramp, heat exhaustion and heat apoplexy were 0.31 (0.18,0.54), 0.13 (0.05,0.34), 0.68 (0.58,2.30) and 0.87 (0.48,1.58). Conclusion: The temperature, relative humidity and the type of heat stroke were the main related factors affecting the prognosis of severe heat stroke.
目的： 分析2013—2017年上海市重症中暑病例死亡的相关因素。 方法： 通过中国疾病预防控制信息系统"高温中暑病例报告系统"，收集2013—2017年上海重症中暑病例资料，包括性别、年龄和中暑类型（热痉挛、热衰竭、热射病和混合型）等，共1 152例，其中死亡组病例115例，存活组病例1 037例。同时，收集2013—2017年上海重症中暑病例发病日期的逐日气象资料，包括最高气温、最低气温、逐日温度、相对湿度、气压、降水量、风速等。比较两组病例发病当日的个体因素以及气象因素差异，并采用多因素logistic回归模型分析重症中暑死亡的相关因素。 结果： 1 152例重症中暑病例年龄为（56.29±18.95）岁，男性843例（73.18%），962例（83.51%）发病日处于热浪期，中暑类型为热痉挛、热衰竭、热射病和混合型的病例分别有322（27.95%）、170（14.76%）、533（46.27%）和114例（9.90%）。存活组发病当日的日平均气温、日最高气温和日最低气温分别为（32.81±1.99）、（38.20±2.24）、（29.22±1.94）℃，均低于死亡组[（33.76±1.17）、（39.19±1.31）、（29.72±1.66）℃]（P值均<0.001）；日平均相对湿度、日最小相对湿度分别为（60.36±9.75）%、（41.26±9.71）%，均高于死亡组[（54.59±6.89）%、（35.60±7.24）%]（P值均<0.05）。多因素logistic回归模型分析发现，与日平均湿度<60%、中暑类型为混合型的病例相比，日平均湿度≥60%、中暑类型为热痉挛、热衰竭、热射病的病例死亡OR（95%CI）值分别为0.31（0.18，0.54）、0.13（0.05，0.34）、0.68（0.58，2.30）和0.87（0.48，1.58）。 结论： 重症中暑病例发病当日的相对湿度以及中暑类型是重症中暑病例预后的主要相关因素。.
Keywords: Case-control studies; Death; Heat stroke; Risk factors.