Characteristics of pediatric patients with heat-related illness transferred to emergency departments: Descriptive analysis

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 transferred to emergency department (ED) s in Japan. 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 old) with heat-related illness transferred to EDs in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes. Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range [IQR]: 13-16). Most cases occurred in August (47%) and most cases (80%) were associated with sports activities and with outdoor setting (70%). Cases with a body temperature above 40°C were rare (3%). Most cases were admitted to hospitals (75% to a general ward, and 16% to the ICU), and patients admitted to ICU had altered consciousness status with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrest. Most pediatric cases with heat-related illness were middle or high school-aged, occurred in August and were related to outdoor sports activity. Patients admitted to hospitals suffered from altered consciousness status, dehydration and acute kidney injury.