{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:13:39Z","timestamp":1784031219580,"version":"3.55.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Early prediction of multiple organ dysfunction syndrome (MODS) secondary to severe heat stroke (SHS) is crucial for improving patient outcomes. This study aims to develop and validate a risk prediction model for those patients based on immediate assessment indicators on ICU admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred eighty-four cases with SHS in our hospital between July 2009 and April 2024 were retrospectively reviewed, and categorized into non-MODS and MODS groups. Logistic regression analyses were performed to identify risk factors for MODS, and then to construct a risk prediction model, which was visualized by a nomogram. The predictive performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow (HL) test, calibration curve, and decision curve analysis (DCA). Finally, the AUCs of the prediction model was compared with other scoring systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Acute gastrointestinal injury (AGI), heart rate (HR) &amp;gt;100\u202fbpm, a decreased Glasgow Coma Scale (GCS) score, and elevated total bilirubin (TBil) within the first 24\u202fh of ICU admission are identified as independent risk factors for the development of MODS in SHS patients. The model demonstrated good discriminative ability, and the AUC was 0.910 (95% <jats:italic>CI<\/jats:italic>: 0.856\u20130.965). Applying the predictive model to the internal validation dataset demonstrated good discrimination with an AUC of 0.933 (95% <jats:italic>CI<\/jats:italic>: 0.880\u20130.985) and good fit and calibration. The DCA of this model showed a superior clinical net benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The risk prediction model based on AGI, HR, GCS, and TBil shows robust predictive performance and clinical utility, which could serve as a reference for assessing and screening the risk of MODS in SHS patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1481097","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T06:39:32Z","timestamp":1735022372000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Development and validation of a risk prediction model for multiple organ dysfunction syndrome secondary to severe heat stroke based on immediate assessment indicators on ICU admission"],"prefix":"10.3389","volume":"11","author":[{"given":"Entong","family":"Ren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenjiao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huasheng","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S0140-6736(21)01208-3","article-title":"Hot weather and heat extremes: health risks","volume":"398","author":"Ebi","year":"2021","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3861","DOI":"10.1073\/pnas.1617526114","article-title":"Communicating the deadly consequences of global warming for human heat stress","volume":"114","author":"Matthews","year":"2017","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1978","DOI":"10.1056\/NEJMra011089","article-title":"Heat stroke","volume":"346","author":"Bouchama","year":"2002","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e64","DOI":"10.1016\/S2468-2667(20)30256-5","article-title":"The 2020 China report of the lancet countdown on health and climate change","volume":"6","author":"Cai","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1089\/ther.2022.0059","article-title":"Construction and validation of the nomogram based on von Willebrand factor predicting mortality in patients with heatstroke","volume":"13","author":"Wan","year":"2023","journal-title":"Ther Hypothermia Temp Manag"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1177\/0885066619871452","article-title":"Multiple organ dysfunction syndrome","volume":"35","author":"Gourd","year":"2020","journal-title":"J Intensive Care Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1515\/iss-2023-0013","article-title":"Fatal heat stroke based on foudroyant irreversible multiple organ dysfunction in German summer","volume":"8","author":"Lorenz","year":"2023","journal-title":"Innov Surg Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.ajem.2021.08.036","article-title":"The value of the exertional heat stroke score for the prognosis of patients with exertional heat stroke","volume":"50","author":"Li","year":"2021","journal-title":"Am J Emerg Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"456","DOI":"10.3760\/cma.j.issn.cn121094-20190313-00096","article-title":"Comparison of different critical care scoring systems in prognosis evaluation of heat stroke","volume":"38","author":"Cheng","year":"2020","journal-title":"Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. 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