Abstract W MP111: The Impact of Fever on Presentation in Intracerebral Hemorrhage: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study

Abstract

Background: Fever on presentation has been demonstrated to be an independent predictor of poor-outcome after ICH. However, prospective data with post-discharge outcomes are limited. Methods: Associations between fever (≥38°C) on presentation and 3-month outcomes were sought among patients in ERICH, a multicenter, triethnic case-control study of ICH. Patients with missing CT or Glasgow Coma Score (GCS) and those lost to 3-month follow-up were excluded. Rates of fever on presentation were compared across admission characteristics, hospital complications, and 3-month outcomes. Additionally, a multivariate analysis was performed to determine factors associated with fever on presentation. Results: A total of 1644 patients out of 2276 enrolled by 12/31/2013 met inclusion criteria for the analysis. Fever on presentation with ICH was present in 2.4% of patients. In univariate analyses, fever was associated with (all data are % febrile in each group): ICH volume (<15mL: 1.7% , 15-30mL: 2.3%, 30-45mL: 4.7%, 45-60: 6.6%, >60: 2.9%, p=0.03), higher ED GCS (3-4: 1.8%, 5-12: 3.0% 13-15: 6.6%, p=0.004), and WBC > 10 (yes, 3.4% vs. no, 1.7% p=0.03). Additionally, borderline significance was seen with race (white 3.1%, black 2.9%, Hispanic 1.1%, p=0.06) and ICH Location (lobar 3.9%, primary IVH 3.8%, Deep 1.6%, Brainstem 2.2%, cerebellum 1.7%, p=0.06). Fever on presentation was not associated with 3-month outcomes (mRS 0-2: 2.1%;3-5:1.9%; 6: 3.2%, p=0.45). In a multivariate analysis, fever was associated with GCS (OR 0.9, 95% CI 0.83-0.97) and white or black race (reference Hispanic; white OR 3.0 95% CI 1.14-7.88; Black OR 2.68, 95% CI 1.04-6.96). Conclusion: Fever is relatively uncommon at admission and does not appear to be associated with poor outcomes.