title: An early rise in body temperature is related to unfavorable outcome after stroke: data from the PAIS study.
abstract: Subfebrile temperature or fever is present in about a third of patients on the first day after stroke onset and is associated with poor outcome. However, the temporal profile of this association is not well established. We aimed to assess the relationship between body temperature on admission as well as the change in body temperature from admission to 24 h thereafter and functional outcome and death. We analyzed data of 1,332 patients admitted within 12 h of stroke onset. The relation between body temperature on admission or the change in body temperature from admission to 24 h thereafter (adjusted for body temperature on admission) on the one hand and unfavorable outcome (death, or a modified Rankin Scale score >2) at 3 months on the other were expressed as odds ratio per 1.0°C increase in body temperature. Adjustments for potential confounders were made with a multiple logistic regression model. No relation was found between admission body temperature and poor outcome (aOR 1.06; 95% CI 0.85-1.32) and death (aOR 1.23; 95% CI 0.95-1.60). In contrast, increased body temperature in the first 24 h after stroke onset was associated with poor outcome (aOR 1.30; 95% CI 1.05-1.63) and death (aOR 1.51; 95% CI 1.15-1.98). An early rise in body temperature rather than high body temperature on admission is a risk factor for unfavorable outcome in patients with acute stroke.
authors.affiliation: Department of Neurology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. m.denhertog@erasmusmc.nl
authors.forename: Heleen M
authors.initials: HM
authors.lastname: den Hertog
authors.forename: H Bart
authors.initials: HB
authors.lastname: van der Worp
authors.forename: H Maarten A
authors.initials: HM
authors.lastname: van Gemert
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Jan
authors.initials: J
authors.lastname: van Gijn
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: Diederik W J
authors.initials: DW
authors.lastname: Dippel
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000368:Aged; D058633:Antipyretics / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000188:drug therapy / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D058633:Antipyretics; D000082:Acetaminophen