Risk factors for fever in critically ill patients with acute new-onset stroke.
OBJECTIVE
The purpose of this project was to identify risk factors for fever among critically ill patients with acute new-onset stroke, treated in a neurological intensive care unit (NICU). The frequency and risk factors for fever in the stroke patients during the first 7 days after admission were retrospectively studied.


METHODS
Fever was defined as a patient's axillary temperature >37.5 degrees C in two separate measurements or >37.8 degrees C in one single measurement. Multivariable logistic regressions were applied to analyse the risk factors for any fever, explained infectious fever and unexplained fever. One hundred and thirty-seven patients were included in the final analysis.


RESULTS
Febrile episodes occurred in 65% (89/137) of the patients; 48.9% of the fever were explained by infection (predominantly pneumonia or bronchitis), and 15.3% were unexplained despite a complete diagnostic evaluation. Significant risk factors for any fever included age 65 years or older, impaired consciousness, extremity paralysis (muscle force < or = grade 3), center venous catheterization and tracheal intubation. In addition to those risk factors, the length of the stay at NICU before the fever was also a significant risk factor for explained infectious fever. Brain midline shift and initial serum leucocyte count more than 12.0 x 10(9)/l were significant risk factors for unexplained fever.


CONCLUSIONS
These results suggest that critically ill and new-onset stroke patients treated in NICU often have fever. The risk factors for different types of fever vary considerably.
Department of Neurology, Zhongda Hospital, Southeast University, Nanjing 210009, China. yanfuling218@163.com
Fuling
F
Yan
Daopei
D
Zhang
Haiqing
H
Xu
Haijian
H
Guo
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003244:Consciousness Disorders / Q000453:epidemiology; D016638:Critical Illness; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007958:Leukocyte Count / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010243:Paralysis / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*