title: Risk Factors to Predict Postoperative Fever After Coil Embolization of Ruptured Intracranial Aneurysms.
abstract: OBJECTIVE
  To investigate risk factors to predict postoperative fever after endovascular treatment of ruptured intracranial aneurysms.
  
  
  METHODS
  Patients undergoing endovascular coiling to treat subarachnoid hemorrhage in Nantong University between November 2011 and September 2014 were retrospectively reviewed. Postoperative temperature and patient demographic data, admission status, characteristic features of aneurysms, and endovascular coiling procedure were documented and analyzed. There were 336 consecutive patients included in this study, and 111 were classified as febrile (tympanic temperature >38.3°C for at least 2 consecutive days).
  
  
  RESULTS
  Univariate analysis demonstrated that age, interval from onset of subarachnoid hemorrhage to operation, history of hypertension and smoking, Hunt and Hess grade, Fisher grade, temperature before coiling, leukocyte count on admission, and infectious complications were correlated with postoperative fever. Five variables were independent risk factors to predict fever by multivariate logistic regression: age >70 years (odds ratio [OR] = 2.6, 95% confidence interval [CI] = 1.2-5.6), Fisher grade 3 or 4 (OR = 2.2, 95% CI = 1.1-4.3), leukocyte count >10,000/mm(3) on admission (OR = 2.3, 95% CI = 1.3-4.0), temperature >37.5°C before coiling (OR = 4.6, 95% CI = 2.0-10.7), and infectious complications (OR = 4.4, 95% CI = 2.2-8.6).
  
  
  CONCLUSIONS
  Postoperative fever after coil embolization was predicted by changeable and unchangeable risk factors in subarachnoid hemorrhage. However, characteristic features of aneurysms and the coiling procedure had no impact on development of postoperative fever. Preventing any infectious complications, lowering temperature before embolization, and draining bloody cerebrospinal fluid may assist in the prevention of subsequent fever.
authors.affiliation: Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Kefu
authors.initials: K
authors.lastname: Cai
authors.affiliation: Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Shen
authors.affiliation: Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Yaohui
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China. Electronic address: charlsone@163.com.
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Ji
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000628:therapy*; D015984:Causality; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016896:Treatment Outcome
keywords: Coil embolization; Fever; Intracranial aneurysm; Risk factors