Serum enzymes in heat stroke: prognostic implication

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 43; no. 7; pp. 1182 - 1187
• Main Authors: Alzeer, Abdulaziz H, El-Hazmi, Mohsen A. F, Warsy, Arjumand S, Ansari, Ziauddin A, Yrkendi, Mohammed S
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Washington, DC Am Assoc Clin Chem 01-07-1997; American Association for Clinical Chemistry
• Subjects: Aged; Alanine Transaminase - blood; Aspartate Aminotransferases - blood; Biological and medical sciences; Body Temperature; Creatine Kinase - blood; Electrocardiography; Female; Heat Stroke - enzymology; Humans; Isoenzymes; L-Lactate Dehydrogenase - blood; Male; Medical sciences; Middle Aged; Miscellaneous; Prognosis; Reference Values; ROC Curve; Saudi Arabia; Traumas. Diseases due to physical agents; Saudi Arabia; Asia; Human; Biological fluid; Biochemical analysis; Prognosis; Enzyme; Creatine kinase; Transferases; Biological marker; Exploration; L-Lactate dehydrogenase; Transaminases; Aspartate transaminase; Clinical biology; Heat stroke; Alanine transaminase; Serum; Oxidoreductases
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1093/clinchem/43.7.1182

We measured serum creatine kinase (CK), lactate dehydrogenase (LD), aspartate aminotransferase (AST), and serum alanine aminotransferase (ALT) in 26 heat stroke (HS) victims and 10 control (non-heat-exhausted) subjects during annual Hajj in Makkah, Saudi Arabia. On admission to the HS treatment unit, serum CK, AST, ALT, and LD were higher in HS victims than controls (P < 0.05), and at 6, 12, and 24 h were higher than baseline concentration. The patient group was divided into three groups, (a) those who had a quick recovery, (b) those who were critically ill until the end of the Hajj period (7 days), and (c) those who died. Serum enzymes at the time of admission were significantly higher (P < 0.05) in the nonsurviving group (n = 6) and the severely ill (n = 9) than in those who had a quick recovery (n = 11). ROC curves were plotted for each enzyme. The most useful indicator was LD, as it could distinguish significantly between the groups who died and those who had a quick recovery (area under the curve = 0.991 +/- 0.0286). It was followed by CK and AST as useful prognostic factors. When compared with ROC curves for body temperature, anion gap, and serum potassium, the enzyme results were superior prognostic indicators.