TY - JOUR
T1 - When should a heat-tolerance test be scheduled after clinical recovery from an exertional heat illness?
AU - Schermann, Haggai
AU - Hazut-Krauthammer, Shir
AU - Weksler, Yael
AU - Spitzer, Sagi
AU - Epstein, Yoram
AU - Kalmanovich, Gary
AU - Yanovich, Ran
N1 - Publisher Copyright:
Ó by the National Athletic Trainers’ Association, Inc
PY - 2020/3
Y1 - 2020/3
N2 - Objective: Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants after either EHS or other EHI who were tested earlier (≤6-week group) versus those who were tested later (>6-week group) to verify the hypothesis. Design: Cohort study. Setting: Data obtained from records of military athletes who experienced EHS or EHI. Patients or Other Participants: All participants who underwent HTT after EHI or EHS experienced between 2014 and 2018 and for whom complete data regarding the severity of the event (rectal temperature, neurologic symptoms, and laboratory results) and HTT results were available were included. Participants with suspected EHS and those with other EHIs were evaluated separately. Main Outcome Measure(s): The percentages of participants with HI and mean probability of heat tolerance were compared between those tested within 6 weeks of the event and those tested later. Results: A total of 186 participants were included in this study (EHS: 12 in the <6-week group, 9 in the >6-week group; EHI: 94 in the <6-week group, 71 in the >6-week group). In the EHS group, the percentages with HI (33% versus 44%, P = .67) and mean probability of heat tolerance (0.82 versus 0.82, P = .98) did not differ. In the EHI group, participants who were tested after 6 weeks had a greater chance of being diagnosed with HI (38% versus 21.3%, P < .02) Conclusions: The HTT results were similar between participants with EHS who were tested early (<6 weeks) and those tested late (>6 weeks). Further investigation of heat-tolerance changes in larger cohorts of patients after EHS is required to verify the theory of transient HI.
AB - Objective: Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants after either EHS or other EHI who were tested earlier (≤6-week group) versus those who were tested later (>6-week group) to verify the hypothesis. Design: Cohort study. Setting: Data obtained from records of military athletes who experienced EHS or EHI. Patients or Other Participants: All participants who underwent HTT after EHI or EHS experienced between 2014 and 2018 and for whom complete data regarding the severity of the event (rectal temperature, neurologic symptoms, and laboratory results) and HTT results were available were included. Participants with suspected EHS and those with other EHIs were evaluated separately. Main Outcome Measure(s): The percentages of participants with HI and mean probability of heat tolerance were compared between those tested within 6 weeks of the event and those tested later. Results: A total of 186 participants were included in this study (EHS: 12 in the <6-week group, 9 in the >6-week group; EHI: 94 in the <6-week group, 71 in the >6-week group). In the EHS group, the percentages with HI (33% versus 44%, P = .67) and mean probability of heat tolerance (0.82 versus 0.82, P = .98) did not differ. In the EHI group, participants who were tested after 6 weeks had a greater chance of being diagnosed with HI (38% versus 21.3%, P < .02) Conclusions: The HTT results were similar between participants with EHS who were tested early (<6 weeks) and those tested late (>6 weeks). Further investigation of heat-tolerance changes in larger cohorts of patients after EHS is required to verify the theory of transient HI.
KW - Exertional heat stroke
KW - Heat intolerance
KW - Probability of heat tolerance
KW - Return to duty
UR - http://www.scopus.com/inward/record.url?scp=85082029228&partnerID=8YFLogxK
U2 - 10.4085/1062-6050-478-18
DO - 10.4085/1062-6050-478-18
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C2 - 31986100
AN - SCOPUS:85082029228
SN - 1062-6050
VL - 55
SP - 289
EP - 294
JO - Journal of Athletic Training
JF - Journal of Athletic Training
IS - 3
ER -