{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:36:39Z","timestamp":1779892599805,"version":"3.53.1"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2018,9,8]],"date-time":"2018-09-08T00:00:00Z","timestamp":1536364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The Japanese Association for Acute Medicine Committee recently proposed a novel classification system for the severity of heat-related illnesses. The illnesses are simply classified into three stages based on symptoms and management or treatment. Stages I, II, and III broadly correspond to heat cramp and syncope, heat exhaustion, and heat stroke, respectively. Our objective was to examine whether this novel severity classification is useful in the diagnosis by healthcare professionals of patients with severe heat-related illness and organ failure. A nationwide surveillance study of heat-related illnesses was conducted between 1 June and 30 September 2012, at emergency departments in Japan. Among the 2130 patients who attended 102 emergency departments, the severity of their heat-related illness was recorded for 1799 patients, who were included in this study. In the patients with heat cramp and syncope or heat exhaustion (but not heat stroke), the blood test data (alanine aminotransferase, creatinine, blood urea nitrogen, and platelet counts) for those classified as Stage III were significantly higher than those of patients classified as Stage I or II. There were no deaths among the patients classified as Stage I. This novel classification may avoid underestimating the severity of heat-related illness.<\/jats:p>","DOI":"10.3390\/ijerph15091962","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T10:28:57Z","timestamp":1536575337000},"page":"1962","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012)"],"prefix":"10.3390","volume":"15","author":[{"given":"Takahiro","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0981-847X","authenticated-orcid":false,"given":"Motoki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Todani","sequence":"additional","affiliation":[{"name":"Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Hifumi","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care medicine, St. Luke\u2019s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1072-7089","authenticated-orcid":false,"given":"Yutaka","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Medicine, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Shimazaki","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, 1-1 Tsuruga-machi, Aizuwakamatsu, Fukushima 965-8611, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-704X","authenticated-orcid":false,"given":"Shoji","family":"Yokobori","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Takauji","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Wakasugi","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center, Toyama University Hospital, 2630, Sugitani, Toyama City, Toyama 930-0152, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama City, Wakayama 640-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1 Iso, Urasoe, Okinawa 901-2132, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Moriya","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama City, Saitama 330-8503, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Japan Sport Council, 2-8-35 Kita-Aoyama, Minato-ku, Tokyo 107-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiko","family":"Tonouchi","sequence":"additional","affiliation":[{"name":"Japan Meteorological Business Support Center, To-nen Bld, 3-17 Kanda-Nishikicho, Chiyoda-ku, Tokyo 101-0054, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Yokota","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasufumi","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Tsuruta","sequence":"additional","affiliation":[{"name":"Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"},{"name":"Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1056\/NEJMra011089","article-title":"Heat stroke","volume":"346","author":"Bouchama","year":"2002","journal-title":"NeW Eng. 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