title: Factors Associated with Fever in Intracerebral Hemorrhage.
abstract: BACKGROUND
  Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever.
  
  
  METHODS
  A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection.
  
  
  RESULTS
  Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P < .0001), and surgical evacuation (OR = 6.78, P < .0001) were significant predictors of fever. Infectious fever (OR = 5.26, P = .004), EVD (OR = 4.86, P = .01), and surgical evacuation (OR = 4.77, P = .04) correlated with prolonged LOS when dichotomized using a median of 15 days.
  
  
  CONCLUSIONS
  Fever is common in ICH patients and is not associated with a clear infectious etiology in the majority of patients. Patients with noninfectious fever have higher in-hospital mortality, but survivors have shorter LOS. Further studies are warranted to better understand fevers in ICH.
authors.affiliation: Division of Vascular Neurology, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio. Electronic address: sabreena.gillow@gmail.com.
authors.forename: Sabreena J
authors.initials: SJ
authors.lastname: Gillow
authors.affiliation: Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
authors.forename: Bichun
authors.initials: B
authors.lastname: Ouyang
authors.affiliation: Section of Cerebrovascular Disease and Neurocritical Care, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Vivien H
authors.initials: VH
authors.lastname: Lee
authors.affiliation: Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
authors.forename: Sayona
authors.initials: S
authors.lastname: John
mesh_terms: D001833:Body Temperature Regulation; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000401:mortality / Q000628:therapy; D016009:Chi-Square Distribution; D005260:Female; D005334:Fever / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Fever; central fever; intracerebral hemorrhage; noninfectious fever