Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2024; 30(4): 346-366
Published online Jan 28, 2024. doi: 10.3748/wjg.v30.i4.346
Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes: A multicentre, retrospective, observational study
Yu-Cong Wang, Xin-Yang Jin, Zheng Lei, Xiao-Jiao Liu, Yu Liu, Bang-Guo Zhang, Jian Gong, Lie-Tao Wang, Lv-Yuan Shi, Ding-Yuan Wan, Xin Fu, Lu-Ping Wang, Ai-Jia Ma, Yi-Song Cheng, Jing Yang, Min He, Xiao-Dong Jin, Yan Kang, Bo Wang, Zhong-Wei Zhang, Qin Wu
Yu-Cong Wang, Lie-Tao Wang, Lv-Yuan Shi, Ding-Yuan Wan, Xin Fu, Lu-Ping Wang, Ai-Jia Ma, Yi-Song Cheng, Jing Yang, Min He, Xiao-Dong Jin, Yan Kang, Bo Wang, Zhong-Wei Zhang, Qin Wu, Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Xin-Yang Jin, School of Pharmacy, Macau University of Science and Technology, Macau 999078, China
Zheng Lei, Department of Critical Care Medicine, The First People's Hospital of Ziyang City, Ziyang 641399, Sichuan Province, China
Xiao-Jiao Liu, Department of Critical Care Medicine, The First People's Hospital of Guanghan City, Chengdu 618399, Sichuan Province, China
Yu Liu, Department of Critical Care Medicine, Lezhi County Traditional Chinese Medicine Hospital, Chengdu 641599, Sichuan Province, China
Bang-Guo Zhang, Department of Critical Care Medicine, Chengdu Qingbaijiang District People's Hospital, Chengdu 610399, Sichuan Province, China
Jian Gong, Department of Critical Care Medicine, Ziyang People's Hospital, Chengdu 641399, Sichuan Province, China
Co-first authors: Yu-Cong Wang and Xin-Yang Jin.
Co-corresponding authors: Zhong-Wei Zhang and Qin Wu.
Author contributions: Kang Y, Jin XD, Wang B, Zhang ZW, Wu Q, Yang J, He M, Cheng YS, Wang YC, Gong J, Jin XY, Lei Z contributed to the conception and design of the study, Wang YC, Wang LT, Shi LY, Wan DY, Fu X, Wang LP, Ma AJ, Liu XJ, Jin XY, Lei Z contributed to the acquisition of data, Wang YC, Wang LT, Shi LY, Wan DY, Gong J, Zhang BG, Liu Y, Jin XY, Lei Z contributed to the analysis and interpretation of the data. Kang Y, Jin XD, Wang B, Zhang ZW, Wu Q, Yang J, He M, Cheng YS, Wang YC, Wang LT, Shi LY, Wan DY, Fu X, Wang LP, Ma AJ, Gong J, Zhang BG, Liu Y, Jin XY, Lei Z drafted or provided critical revision of the article. Kang Y, Jin XD, Wang B, Zhang ZW, Wu Q, Yang J, He M, Cheng YS, Wang YC, Wang LT, Shi LY, Wan DY, Fu X, Wang LP, Ma AJ, Gong J, Zhang BG, Liu Y, Jin XY, Lei Z read and approved the final manuscript. The reasons for designating Wang YC and Jin XY as co-first authors, and Wu Q and Zhang ZW as co-corresponding authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-corresponding authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Wang YC and Jin XY contributed efforts of equal substance throughout the research process. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Zhang ZW and Wu Q as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by National Key R&D Program of China, No. 2022YFC2504500; and 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZYGD23012.
Institutional review board statement: Ethical approval for this study was obtained from the Biomedical Ethics Review Committee of the West China Hospital of Sichuan University (approval No. SCU-2022-1542), in accordance with the principles outlined in the Declaration of Helsinki.
Informed consent statement: Given the retrospective nature of this study, the requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request at 716461751@qq.com or qinwu0221@gmail.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qin Wu, MD, Doctor, Professor, Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. qinwu0221@gmail.com
Received: October 3, 2023
Peer-review started: October 3, 2023
First decision: December 6, 2023
Revised: December 17, 2023
Accepted: January 9, 2024
Article in press: January 9, 2024
Published online: January 28, 2024
Processing time: 115 Days and 1.7 Hours
ARTICLE HIGHLIGHTS
Research background

Extreme heat exposure is a growing health problem. The effects of heat on the gastrointestinal tract is unknown.

Research motivation

It was intended to summarize the effects of heat on the gastrointestinal (GI) tract of intensive care unit (ICU) patients.

Research objectives

This study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on outcomes.

Research methods

We conducted a retrospective, multi-center, observational cohort study to analyze outcomes between patients.

Research results

The timing and duration of gastrointestinal symptoms affects heatstroke patient's prognosis and enteral nutrition (EN) therapy. The status of EN therapy is related to heatstroke patients’ outcomes. Advanced age and low Glasgow coma scale (GCS) scores are risk factors for gastrointestinal symptoms in heatstroke patients.

Research conclusions

The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.

Research perspectives

This was a retrospective, multi-center, observational cohort study that involved patients admitted to 83 ICUs located in 16 cities in the Sichuan Province, China between June 1 and October 31, 2022. Results showed older heatstroke patients with a lower GCS score on admission were more likely to experience GI symptoms, which had statistical difference. Clinicians should pay attention to the time at which heatstroke patients started manifesting gastrointestinal symptoms, as well as the duration of said symptoms, to ensure that patients are timely treated with the proper EN therapy and have the best prognosis possible.