title: Effect of paracetamol (acetaminophen) on body temperature in acute stroke: A meta-analysis.
abstract: OBJECTIVE
  The objective of this study was to assess the efficacy of paracetamol (acetaminophen) on body temperature in acute stroke.
  
  
  METHODS
  Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and the World Health Organization (WHO) International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomized controlled trials (RCT) and controlled clinical trials (CCT) regarding the efficacy of paracetamol (acetaminophen) on body temperature in acute stroke. Two reviewers independently performed data extraction and quality assessment. Data were analyzed using RevMan 5.3 software by the Cochrane Collaboration.
  
  
  RESULTS
  Five studies were included. To compare the efficacy of paracetamol (acetaminophen) in acute stroke, the pooled RR (Risk Ratio) and its 95% CI of body temperature reduction at 24h from the start of treatment were -0.3 (95% CI: -0.52 to -0.08), with statistical significance (P=0.007). Consistently, the pooled RR (Risk Ratio) and its 95% CI of body temperature at 24h from the start of treatment were -0.22 (-0.29, -0.15), with statistical significance (P<0.00001). When analyzing the body temperature reduction after 5days from the start of treatment, the pooled RR (Risk Ratio) and its 95% CI were 0.04 (95% CI: -0.20 to 0.29), with no statistical significance (P=0.73). For functional outcome (mRS≤2) analysis, the pooled RR and its 95% CI were 1.08 (0.88, 1.32), with no statistical significance (P=0.45). In addition, the difference of serious adverse events between acetaminophen and placebo was 0.86 (95% CI: 0.62 to 1.2), with no statistical significance (P=0.27).
  
  
  CONCLUSIONS
  Acetaminophen was revealed to have some favorable influence in body temperature reduction in acute stroke, but showed no important effect on improving functional outcome and reducing adverse events of patients.
  
  
  CONCLUSIONS
  What is already known on this subject? Paracetamol (acetaminophen) is one of the most commonly used antipyretic drugs and has some capability to reduce body temperature through acting on central nervous system.
  
  
  CONCLUSIONS
  Acetaminophen showed some capability to decrease body temperature for acute stroke. Acetaminophen could not improve functional outcome and reduce adverse events of patients with acute stroke.
authors.affiliation: Intensive Care Unit, Ningbo Fourth Hospital, Zhejiang, China. Electronic address: drfangjunjie@163.com.
authors.forename: Junjie
authors.initials: J
authors.lastname: Fang
authors.affiliation: Intensive Care Unit, Ningbo Fourth Hospital, Zhejiang, China. Electronic address: ptccs@163.com.
authors.forename: Chensong
authors.initials: C
authors.lastname: Chen
authors.affiliation: Intensive Care Unit, Ningbo Fourth Hospital, Zhejiang, China. Electronic address: icuchs@126.com.
authors.forename: Hongsen
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Intensive Care Unit, Ningbo Fourth Hospital, Zhejiang, China. Electronic address: 75727646@qq.com.
authors.forename: Ren
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Critical Care & Emergency Medicine, Shanghai Changzheng Hospital, Shanghai, China. Electronic address: macro118@hotmail.com.
authors.forename: Linhao
authors.initials: L
authors.lastname: Ma
mesh_terms: D000082:Acetaminophen / Q000494:pharmacology*; D058633:Antipyretics / Q000494:pharmacology; D001831:Body Temperature / Q000187:drug effects*; D006801:Humans; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D058633:Antipyretics; D000082:Acetaminophen
keywords: Acetaminophen; Acute stroke; Body temperature; Efficacy; Meta-analysis