The time course and determinants of temperature within the first 48 h after ischaemic stroke.
OBJECTIVE
Previous research has attempted to analyze the relationship between post-stroke hyperthermia and prognosis. These analyses have been hindered by a lack of information about the time course and determinants of temperature change after stroke.


METHODS
Serial temperatures were measured until 48 h after ischaemic stroke in a prospectively recruited cohort. Potential determinants of temperature, including stroke severity [measured using the National Institutes of Health Stroke Scale (NIHSS)], infection and paracetamol use were recorded. Mixed-effects models were used to model serial temperature measurements over time, adjusted for significant determinants.


RESULTS
In 155 patients the mean temperature rose from 36.5 degrees C at the time of stroke to 36.7 degrees C approximately 36 h later. The factors with significant multivariable associations with serial temperatures were: first- and second-order time components, infection, paracetamol administration and the interaction between stroke severity (NIHSS > or =6) and time (all p < 0.1). Patients with admission NIHSS > or =6 had a mean temperature rise of 0.35 degrees C during the first 36 h after stroke, compared with a rise of 0.17 degrees C in those with NIHSS < or =5.


CONCLUSIONS
Temperature spontaneously rises during the first 36 h after stroke, particularly after severer stroke and in the presence of infection.
Wong
Andrew A
AA
Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia. AndrewA_Wong@health.qld.gov.au
Davis
James P
JP
Schluter
Philip J
PJ
Henderson
Robert D
RD
O'Sullivan
John D
JD
Read
Stephen J
SJ
D000082:Acetaminophen / Q000494:pharmacology / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000494:pharmacology / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications; D001831:Body Temperature / Q000187:drug effects; D002545:Brain Ischemia / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen