IMR Press / JIN / Volume 21 / Issue 6 / DOI: 10.31083/j.jin2106156
Open Access Original Research
Association of Early Increase in Body Temperature with Symptomatic Intracranial Hemorrhage and Unfavorable Outcome Following Endovascular Therapy in Patients with Large Vessel Occlusion Stroke
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1 Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, 528100 Foshan, Guangdong, China
2 Department of Neurology, Radiology, Boston University School of Medicine, Boston, MA 02118, USA
3 School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, BT7 1NN County Antrim, Northern Ireland, UK
4 Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA
5 School of Medicine, Cardiff University, CF14 4XN Wales, UK
6 Foshan Sanshui District People's Hospital, 528100 Foshan, Guangdong, China
7 School of Medicine, Shaoguan University, 512158 Shaoguan, Guangdong, China
8 Faculty of Chinese Medicine Science, Guangxi University of Chinese Medicine, 530011 Nanning, Guangxi, China
9 Faculty of Humanities and Social Sciences, Macao Polytechnic University, 999078 Macao, China
*Correspondence: P2009495@ipm.edu.mo (Baoxin Chen); yangshuiquan1969@126.com (Shuiquan Yang)
Academic Editor: Giovanni Grasso
J. Integr. Neurosci. 2022, 21(6), 156; https://doi.org/10.31083/j.jin2106156
Submitted: 5 February 2021 | Revised: 8 April 2022 | Accepted: 24 April 2022 | Published: 20 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Introduction: The aim of this study was to investigate for possible associations between an early increase in body temperature within 24 hours of endovascular therapy (EVT) for large vessel occlusion stroke and the presence of symptomatic intracranial hemorrhage (sICH) and other clinical outcomes. Methods: This was a retrospective study of consecutive patients with large vessel occlusion stroke who were treated with EVT from August 2018 to June 2021. Patients were divided into two groups based on the presence of fever, as defined by a Peak Body Temperature (PBT) of 37.3 °C. The presence of sICH and other clinical outcomes were compared between the two groups. Results: The median NIHSS admission score (IQR) was 16.0 (12.0, 21.0), with higher NIHSS scores in the PBT 37.3 °C group than in the PBT <37.3 °C group (18 vs 14, respectively; p = 0.002). There were no differences in clinical outcomes at 3 months between patients with PBT <37.3 °C and patients with PBT between 37.3 °C and 38 °C. However, patients with PBT 38 °C had an increased risk of sICH (adjusted odds ratio (OR) = 8.8, 95% confidence interval (95% CI): 1.7–46.0; p = 0.01), increased inpatient death or hospice discharge (OR = 10.5, 95% CI: 2.0–53.9; p = 0.005), poorer clinical outcome (OR = 25.6, 95% CI: 5.2–126.8; p < 0.001), and increased 3-month mortality (OR = 6.6, 95% CI: 1.8–24.6; p = 0.01). Conclusions: Elevated PBT (38 °C) within 24 hours of EVT was significantly associated with an increased incidence of symptomatic intracranial hemorrhage, discharge to hospice or inpatient death, poorer clinical outcome and 3-month mortality, and with less functional independence. Further large-scale, prospective and multicenter trials are needed to confirm these findings.

Keywords
body temperature
symptomatic intracranial hemorrhage
endovascular therapy
ischemic stroke
Funding
FS0AA-KJ218-1301-0012/ Foshan Medical Technology Innovation Platform Construction Foundation, China
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