Abstract
BackgroundLimited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization. We aimed to explore the prognostic value of BT in predicting outcomes of stroke recovery at 3 months poststroke.MethodsWe retrospectively analyzed the relationship among BT levels as a continuous variable, with fever (BT ≥ 37.5℃) as a binary variable, and obtained several outcomes of interest. Subjects were stratified according to successful recanalization (thrombolysis in cerebral infarction scores of 2b-3) following MT. Functional independence was defined as a modified Rankin scale (mRS) score of 0–2.ResultsIn total, 258 patients were included. The proportion of patients with functional independence was significantly lower among patients with BT ≥ 37.5℃ than among those with BT < 37.5 °C (45.3 % versus 23.0 %; P < 0.001). In the multivariate analysis, hyperpyrexia (especially BT ≥ 38 °C) was significantly associated with poor 3-month outcomes in patients treated with MT. Subgroup analysis was conducted by comparing the successful recanalization group with the non-recanalization group, showing that BT ≥ 37.5 °C was associated with a significantly lower proportion of functional independence in the recanalized patients. Besides, the Kaplan-Meier model showed that the fever group had significantly lower survival rates than the non-fever group during the 3-month follow-up.ConclusionsIn patients treated with MT, hyperpyrexia is an independent predictor of poststroke outcomes at 3 months, particularly in those with successful recanalization.
Highlights
Limited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization
A number of studies have already proven the correlation between BT and clinical outcomes in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis [11, 12], studies evaluating the effect of BT levels on the outcomes of patients treated with MT are scarce
The aim of the study was to determine whether BT levels have different effects on poststroke recovery in patients treated with MT during the first 3 months poststroke, especially in those with or without successful recanalization
Summary
Limited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization. Recanalization is the main target of treatment for AIS and is associated with good clinical outcomes at 3 months [2]. After MT, approximately 54 % of patients are still unable to achieve functional independence within 3 months, and approximately 15 % of patients die within this timespan [6, 7] These data show that factors other than recanalization status play an important role in the prognosis of MT. Geurts pointed out that the effects of recanalization factors on patient outcomes were not considered, and the effects of mild hypothermia therapy are different in patients with different recanalization statuses of large intracranial vessels, such as non-recanalization and successful recanalization [10]. Considering that the successful recanalization rate with MT is higher than that with intravenous thrombolysis [13, 14] and that a certain incidence of reocclusion still occurs after MT, it is necessary to conduct a study based on different recanalization statuses of patients
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