Admission Body Temperature Predicts Long-Term Mortality After Acute Stroke

Abstract

Background and Purpose-Body temperature is considered crucial in the management of acute stroke patients. Recently hypothermia applied as a therapy for stroke has been demonstrated to be feasible and safe in acute stroke patients. In the present study, we investigated the predictive role of admission body temperature to the long-term mortality in stroke patients. Methods-We studied 390 patients with acute stroke admitted within 6 hours from stroke onset. Admission clinical characteristics (age, sex, admission stroke severity, admission blood glucose, cardiovascular risk factor profile, and stroke subtype) were recorded for patients with hypothermia (body temperature Յ37°C) versus patients with hyperthermia (body temperature Ͼ37°C). Univariately the mortality rates for all patients were studied by Kaplan-Meier statistics. To find independent predictors of long-term mortality for all patients, Cox proportional-hazards models were built. We included all clinical characteristics and body temperature as a continuous variable. Results-Patients with hyperthermia had more severe strokes and more frequently diabetes, whereas no difference was found for the other clinical characteristics. For all patients mortality rate at 60 months after stroke was higher for patients with hyperthermia (73 per 100 cases versus 59 per 10 cases, Pϭ0.001). When body temperature was studied in a multivariate Cox proportional-hazards model, a 1°C increase of admission body temperature independently predicted a 30% relative increase (95% CI, 4% to 57%) in long-term mortality risk. For 3-month survivors we found no association between body temperature and long-term survival when studied in a multivariate Cox proportional hazard model (hazards ratio, 1.11 per 1°C; 95% CI, 0.82 to 1.52). Conclusion-Low body temperature on admission is considered to be an independent predictor of good short-term outcome. The present study suggests that admission body temperature seems to be a major determinant even for long-term mortality after stroke. Hypothermic therapy in the early stage in which body temperature is kept low for a longer period after ictus could be a long-lasting neuroprotective measure.

Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient

“…80 Even an increase of 1°F is a predictor of poorer patient outcome and is an independent factor in short-and long-term mortality rates. 82,129,156,157 The rationale for this additional injury may be related to increased metabolic demands and free radical production. Immediate treatment of the source of the fever will reduce its duration.…”

Reduction of the systemic inflammatory induced by acute cerebral infarction through ultra-early thrombolytic therapy

“…Elevated body temperature is also a risk factor for the hemorrhagic transformation of acute ischemic stroke when recombinant tissue-type plasminogen activator treatment is not applied to patients (15). Some studies have found that the higher and sooner the body temperature increases in the acute phase of ischemic stroke, the more severe the brain damage is likely to be; however, this correlation exists only within the first 24 h of stroke (16,17).…”

Investigational Therapies for Ischemic Stroke: Neuroprotection and Neurorecovery

“…Side effects of hypothermia appear to occur more frequently with each degree of Celsius reduction in temperature. Temperature reductions to 35°C have been shown to be feasible and safe with surface cooling in awake, acute ischemic stroke patients, in combination with meperidine to treat shivering [46]. The ICTuS-L trial [43] found intravascular cooling to 33°C in combination with intravascular thrombolysis safe and feasible.…”