Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan

Abstract

Objective Children are particularly vulnerable to heat-related illnesses due to their unique physiological and behavioral characteristics. Understanding the epidemiology and clinical features of heat-related illnesses in children is crucial for guiding targeted preventive measures and management strategies. This descriptive study aims to investigate the characteristics of pediatric patients with heat-related illness who were transferred to emergency departments in Japan. Methods This study was a secondary analysis of the Heatstroke Study, led by the Heatstroke and Hypothermia Surveillance Committee of the Japanese Association for Acute Medicine. This study included pediatric patients (<18 years) with heat-related illness transferred to emergency departments in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes. Results Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range, 13–16 years). Most cases occurred in August (47%), and most (80%) were associated with sports activities and with outdoor settings (70%). Cases with a body temperature above 40 °C were rare (3.4%). Most cases were admitted to hospitals (75% to the general ward and 16% to the intensive care unit), and patients admitted to the intensive care unit had altered consciousness with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrests. Conclusion Most pediatric cases with heat-related illness were middle or high school students, occurred in August, and were related to outdoor sports activity. Patients admitted to hospitals suffered altered consciousness, dehydration, and acute kidney injury.