Some patients with heatstroke also experience intracerebral hemorrhage (ICH). However, clinical case reports of heatstroke-induced ICH are rare. The risk factors for cerebral hemorrhage after heatstroke remain unknown. The present study evaluated the clinical characteristics and risk factors of patients with heatstroke-related ICH. In this retrospective observational study, we collected data on all ICHs after heatstroke occurred between 2012 and 2022. The characteristics of patients with heatstroke-induced ICH were described. The risk factors for cerebral hemorrhage after heatstroke were examined using logistic regression analysis. In total, 177 patients were included in this study, and 11 patients with ICH secondary to heatstroke were identified. Variables with P values of <.05 in univariate models, comparing the cerebral hemorrhage and control groups, included heatstroke cause, temperature, heart rate, respiratory rate, vasopressor use, mechanical ventilation use, Acute Physiology and Chronic Health Evaluation II, total bilirubin, creatinine, platelet count, prothrombin time, procalcitonin, creatine kinase, disseminated intravascular coagulation (DIC) occurrence, and DIC score. Multivariate logistic regression showed that heatstroke patients with higher DIC scores (odds ratio, 18.402, 95% confidence interval, 1.384–244.763, P = .027) and higher creatine kinase levels (odds ratio, 1.021, 95% confidence interval, 1.002–1.041, P = .033) were at a higher risk of developing ICH. The death rate was higher in the cerebral hemorrhage group than in the control group (P = .042). Heatstroke-related cerebral hemorrhage may be associated with elevated creatinine levels and DIC severity (International Society on Thrombosis and Hemostasis score) after heatstroke, and heatstroke with cerebral hemorrhage may accelerate death.

BACKGROUND: he central nervous system is a critical target of severe heatstroke, with oxidative stress and multi-organelle damage being the key pathogenic mechanisms. However, research on endogenous antioxidant defense remains limited. In this study, we aimed to characterize neuronal oxidative damage as a key heatstroke pathological mechanism and assess the neuroprotective effects of nuclear factor E2-related factor 2 (NRF2).

Background: Severe heatstroke patients have a poor prognosis. There are few descriptions of the inflammatory response to heatstroke in clinical studies. Systemic immune-inflammation index (SII) is a new index to reflect the inflammatory state of disease. Methods: This retrospective observational study included patients who had severe heatstroke between 2010 and 2023. Multivariate logistic regression and nomogram were performed to determine the ability of the SII to predict the prognosis of these patients, and subgroup analysis was performed according to SII levels. Results: Of the 177 patients included in our study, 28 (15.8%) died. There was no difference in SII values between the first day (P = 0.810) and the second day (P = 0.184) in multivariate analysis. The SII value of the third day (SII 72) was elevated in patients with heatstroke who died compared to that in those who survived (P = 0.035). In multivariable logistic regression, Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.717; confidence interval [CI], 1.073–2.747; P = 0.024) and SII 72 (OR, 1.001; 95% CI, 1.000–1.002; P = 0.035) were found to be independent predictors of mortality. SII 72 combined with SOFA score distinguished between patients who died and those who survived better than did the separate SOFA score. Patients with SII 72 > 1,000 had poor clinical prognosis. Conclusions: Compared to SII results from the first and second days, third-day results more meaningfully predict poor heatstroke prognosis. SII 72 may be a good indicator and, when combined with SOFA, offers enhanced predictive value.

Background During the coronavirus disease 2019 (COVID-19) pandemic, many people have abused and misused disinfectants, leading to many poisoning incidents. However, there are few clinical case reports of poisoning caused by mixed household disinfectants. This study summarized the clinical characteristics and treatment effects of chlorine poisoning caused by improper mixing of hypochlorite bleach with acidic cleaning agents to improve the understanding of the disease. Methods We retrospectively analyzed the basic data, clinical symptoms, treatment methods, imaging, and other clinical data of seven patients with chlorine poisoning, caused by an improper mixture of hypochlorite bleach and acidic cleaning agents, who were admitted to the National Army Poisoning Treatment Center. Results The seven patients (three men and four women) had an average age of 48.8 years (18–67 years). The average poisoning time (time from exposure to poison to treatment) was 57 h (4–240 h). All seven patients were involved in cleaning bathrooms during the COVID-19 pandemic. Chest computed tomography scans showed bilateral lung effusions or inflammatory changes in five patients and no obvious exudation or inflammatory changes in two. The partial pressure of oxygen decreased in six patients, and respiratory failure occurred in one. Five patients had different degrees of increase in white blood cell count. For treatment, humidified oxygen therapy, non-invasive mechanical ventilation, intravenous corticosteroids, inhaled hormone, bronchial spasmolytics, antibiotics, and other symptomatic and supportive treatments were provided. The average length of hospital stay was 7 days (4–9 days). All seven patients recovered and were discharged. Conclusions Improper mixing of house disinfectants during the COVID-19 pandemic may cause damage to the respiratory system due to chlorine poisoning. Corticosteroids may improve lung exudation in severe cases. Additionally, symptomatic supportive treatment should be performed early.