Abstract
BackgroundHigh body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke.MethodsIn 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months.ResultsBody temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04–0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83–1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48–1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17–1.99) and 1.47 (95% CI, 1.22–1.77), respectively).ConclusionsHigher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.
Highlights
High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown
This study shows that in patients with acute ischemic stroke, higher peak body temperatures on days one, two and three after stroke onset are associated with larger infarct size
Increased body temperature is often thought to be a reflection of extensive cerebral damage, we found an association between increased body temperature and poor functional outcome that was independent of baseline stroke severity
Summary
High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. High body temperatures in the early stage after ischemic stroke have consistently been associated with poor functional outcome [2,3,4,5,6,7,8,9,10,11,12,13]. The association between body temperature and infarct size in patients with ischemic stroke is still controversial, mainly when it comes to the temporal profile of this association. Temperature assessment in all studies was limited to the first 24 h after stroke onset
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