Heat-related illnesses during the 2003 heat wave in an emergency service

Introduction This study describes patients admitted to an urban emergency service in France during the 2003 heat wave. Patients with heat-related illnesses were studied and comparison was made between those who died and survivors. Methods A retrospective study of about 760 records concerning 726 patients aged over 65 years admitted during August 2003 to a French emergency department. Results After review of the medical records, 42 patients had heat-related illnesses. Heat-related illnesses were not diagnosed by the treating physician in any of the patients. The patients were more likely to live in institutional care and used more psychotropic medications. Hyperthermia and acute cognitive impairment were the main reasons for admission to the emergency department. The patients had a higher heart rate and body temperature and more dyspnoea and central nervous system dysfunction than those without heat-related illnesses. Twelve patients (28.6%) with heat-related illnesses died in the emergency unit or after admission to hospital. Temperature, heart rate and plasma creatinine levels were higher in those who died than in survivors with heat-related illnesses. Conclusion Heat-related illnesses are a group of underestimated and underdiagnosed conditions with high morbidity and mortality rates.