The Prognostic Role of Body Temperature in Acute Ischemic or Hemorrhagic Stroke Patients

ABSTRACT

BACKGROUND: Hyperthermia is known to be one of the important poor prognostic factors of ischemic stroke. However, the prognostic role of fever in hemorrhagic stroke is not clear. We investigated whether the prognostic role of fever is influenced by the type of stroke. METHODS: We analyzed the linical data of patients who were admitted to our hospital within three days after the onset of stroke during 28 months. We divided the patients into three groups according to the degree of maximum temperature recorded during the first seven days; no fever ( OR=38.1degrees C) fever. Using the modified Rankin disability scale (MRDS) at discharge, clinical outcome was dichotomized into favorable (MRDS 0~2) and unfavorable (MRDS 3~5) categories. The size of lesion, age, sex, alcohol, diabetes, hypertension, initial glucose level, hypercholesterolemia, heart disease, smoking, previous stroke, and initial National Institutes of Health Stroke Scale (NIHSS) were investigated. RESULTS: Of 217 patients, 46.1% had no fever, 36.9% had low grade fever, and 17.1% had high grade fever. Fever was strongly correlated with outcome in patients with stroke of any type (p<0.05). The size of lesion was also significantly correlated with the degree of fever in patients with ischemic stroke (p=0.01). Multivariate analysis in the logistic model revealed that fever and NIHSS were independent predictors for a poor prognosis. CONCLUSIONS: Fever in patients with acute stroke is an independent poor prognostic factor regardless of stroke type.