SERUM ENZYMES IN HEAT-STROKE - PROGNOSTIC IMPLICATION

We measured serum creatine kinase (CK), lactate dehydrogenase (LD), as partate aminotransferase (AST), and serum alanine aminotransferase (AL T) in 26 heat stroke (HS) victims and 10 control (non-heat-exhausted) subjects during annual Hajj in Makkah, Saudi Arabia. On admission to t he HS treatment unit, serum CK, AST, ALT, and LD were higher in HS vic tims than controls (P < 0.05), and at 6, 12, and 24 h were higher than baseline concentration. The patient group was divided into three grou ps, (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 plott ed for each enzyme. The most useful indicator was LD, as it could dist inguish significantly between the groups who died and those who had a quick recovery (area under the curve = 0.991 +/- 0.0286). It was follo wed by CK and AST as useful prognostic factors. When compared with ROC curves for body temperature, anion gap, and serum potassium, the enzy me results were superior prognostic indicators.