title: Central fever in patients with spontaneous intracerebral hemorrhage: predicting factors and impact on outcome.
abstract: BACKGROUND
  Central fever (CF) is defined as elevated temperature with no identifiable cause. We aimed to identify risk factors for developing CF among patients with spontaneous intracerebral hemorrhage (ICH) and to evaluate the impact of CF on outcome.
  
  
  METHODS
  Patients included in our prospective stroke registry between 1/1/09 and 1/10/10 were studied. We identified patients with CF as those with a temperature ≥38.3°C without evidence for infection or drug fever. Patients with CF were compared to those without fever and those with infectious fever. Demographics, risk factors and imaging data as well as outcome parameters were reviewed.
  
  
  RESULTS
  We identified 95 patients with spontaneous ICH (median age 76, median admission NIHSS 9). CF was identified in 30 patients (32%), infectious etiology was found in 9 patients (9%) and the remaining patients did not develop fever. Baseline variables were similar between the groups except for intra-ventricular extension of the ICH (IVH) and larger ICH volumes that were more common in the CF group (OR = 4.667, 95% CI 1.658-13.135 and OR = 1.013/ml, 95% CI 1.004-1.021). Outcome analysis showed higher mortality rates (80% vs. 36%, p < 0.001) and lower rates of favorable functional outcome defined as a modified Rankin score ≤ 2 at 90 days (0% vs. 53%, p < 0.001) in the CF group.
  
  
  CONCLUSIONS
  The risk of CF is increased in patients with larger ICH and in those with IVH. CF negatively impacts outcome in patients with ICH.
authors: Departments of Neurology, the Agnes Ginges Center of Neurogenetics, Hebrew University-Hadassah Medical Center, P.O. Box 12000, Jerusalem, 91120, Israel. asafh@hadassah.org.il.
authors: Asaf
authors: A
authors: Honig
authors: Departments of Neurology, the Agnes Ginges Center of Neurogenetics, Hebrew University-Hadassah Medical Center, P.O. Box 12000, Jerusalem, 91120, Israel. samer.s.michael@gmail.com.
authors: Samer
authors: S
authors: Michael
authors: Departments of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. rutrut06@gmail.com.
authors: Ruth
authors: R
authors: Eliahou
authors: Departments of Neurology, the Agnes Ginges Center of Neurogenetics, Hebrew University-Hadassah Medical Center, P.O. Box 12000, Jerusalem, 91120, Israel. leker@hadassah.org.il.
authors: Ronen R
authors: RR
authors: Leker
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D014695:Cerebral Ventriculography; D005260:Female; D005334:Fever / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
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