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AI-DRAFTED — PHYSICIAN REVIEW IN PROGRESSThe citation for this entry was checked against Crossref and PubMed, but its summary and interpretation were drafted by an AI model from the published abstract and have not yet been individually read by a physician. Read the linked source before relying on this operationally.
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Clinical Characteristics, Complications, and Outcomes of Heat Stroke Among Pilgrims During the Hajj Mass Gathering: A Prospective Cohort Study[1]

Aldardeer N, Harisi A, Alzahrani SS, Alkhani N, Alenazi AO, et al. · 2026 · Open Access Emerg Med

Summary

Prospective exploratory cohort across nine hospitals of adult Hajj pilgrims (>=18) admitted with confirmed heat stroke (core temperature >=40C plus CNS dysfunction). Twenty-three patients (mean age 65.1 +/- 10.5 years, 56.5% male); 15 (65.2%) were discharged from the treating ICU and 8 (34.8%) were transferred to an advanced referral center, with transfer used as a pragmatic surrogate for greater severity. The transferred group had higher admission creatinine (165.5 vs 130.5), markedly higher peak creatinine (275.9 vs 143.0, p=0.001), higher peak urea (17.4 vs 11.0, p=0.01), higher peak AST (p=0.015), and lower nadir platelets (p=0.007); they required mechanical ventilation far more often (75.0% vs 26.7%, p=0.026) and for longer (p=0.019). Authors stress the small sample makes this exploratory and that transfer status is confounded by health-system factors, not a validated severity predictor.

So what

The clinical-progression complement to the heat-prediction and heat-communication shelves: those pages forecast and prevent the heat presentation; this one describes what the classical exotic heat stroke that reaches an ICU actually does to the organs — an acute kidney injury / hepatic / thrombocytopenic / respiratory-failure picture concentrated in an elderly pilgrim population (mean age 65). It reinforces the geriatric-pilgrim page's core claim that the elderly pilgrim is the heat-fatality archetype, and gives a medical director a concrete organ-dysfunction checklist for the sickest tail. Honest limits travel with it — n=23, exploratory, transfer confounded by system capacity — so it should be cited as a clinical-picture description, not a triage rule.

Key findings

  • Prospective cohort, 9 hospitals, adult Hajj pilgrims with heat stroke (core >=40C + CNS dysfunction)
  • n=23, mean age 65.1 +/- 10.5, 56.5% male — the elderly-pilgrim heat archetype
  • 15 (65.2%) ICU-discharged vs 8 (34.8%) transferred to advanced referral (transfer = severity surrogate)
  • Severe tail = AKI (peak creatinine 275.9 vs 143, p=0.001), high urea/AST, thrombocytopenia, mechanical ventilation 75% vs 26.7%
  • Explicitly exploratory (small n; transfer confounded by system factors) — clinical picture, not a triage rule

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