title: Early Predictors of Fever in Patients with Aneurysmal Subarachnoid Hemorrhage.
abstract: BACKGROUND
  Fever is commonly observed in patients who have had aneurysmal subarachnoid hemorrhage (SAH), and it has been associated with the occurrence of delayed cerebral ischemia and worse outcomes in previous studies. Frequently, fever is not the result of bacterial infections, and distinction between infection-related fever and fever secondary to brain injury (also referred as central fever) can be challenging.
  
  
  OBJECTIVE
  The current study aimed to identify risk factors on admission for the development of central fever in patients with SAH.
  
  
  METHODS
  Databank analysis was performed using information from demographic data (age, gender), imaging (transcranial Doppler ultrasound, computed tomography, and cerebral angiogram), laboratory (white blood cell count, hemoglobin, renal function, and electrolytes), and clinical assessment (Hunt-Hess and modified Fisher scales on admission, occurrence of fever). A multivariate logistic regression model was created.
  
  
  RESULTS
  Of 55 patients, 32 developed fever during the first 7 days of hospital stay (58%). None of the patients had identifiable bacterial infections during their first week in the neurocritical care unit. Hunt-Hess scale >2 and leukocytosis on admission were associated to the development of central fever, even after correction in a logistic regression model.
  
  
  CONCLUSIONS
  Leukocytosis and a poor neurologic examination on admission might help predict which subset of patients with SAH are at higher risk of developing central fever early in their hospital stay.
authors: Neurology Research Department, Universidade Federal Fluminense, Niteroi, Brazil; Americas Medical City, Rio de Janeiro, Brazil. Electronic address: ivanuerj@gmail.com.
authors: Ivan
authors: I
authors: Rocha Ferreira da Silva
authors: Insituto D'Or de Ensino e Pesquisa, Rio de Janeiro, Brazil.
authors: Gabriel
authors: G
authors: Rodriguez de Freitas
mesh_terms: D015415:Biomarkers / Q000097:blood; D002533:Cerebral Angiography / Q000379:methods; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D016208:Databases, Factual; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007964:Leukocytosis / Q000097:blood / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D016017:Odds Ratio; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D015415:Biomarkers
keywords: Subarachnoid hemorrhage; aneurysm; fever; predictors