Hyperthermia is not an independent predictor of greater mortality in patients with primary intracerebral hemorrhage.
Andrzej Szczudlik, Wojciech Turaj, Agnieszka Słowik, Jacek Strojny
Med Sci Monit 2002; 8(10): CR702-707
BACKGROUND: Our goal was to identify independent early predictors of 30-day mortality in patients with medically treated primary intracerebral hemorrhage (PICH), and to assess the prognostic significance of hyperthermia in these cases MATERIAL/METHODS: We prospectively studied 152 patients with supratentorial PICH confirmed by CT on admission. We recorded gender, age, severity of neurological deficit on admission (Scandinavian Stroke Scale), level of consciousness at admission and one day later, and maximum body temperature for the first three days after onset. Hematoma size and midline shift were assessed by CT scans. Outcome was measured by either mortality or Barthel Index functional status 30 days after stroke. RESULTS: 59 patients (38.8%) died within 30 days. Patients who died had greater neurological deficit on admission and higher maximum temperature within the first 24 hours after admission, and were more likely to have impaired consciousness on admission and after 24 hours, as well as large hematoma and midline shift (P<0.05 for all differences). However, statistically only severity of neurological deficit was an independent predictor of 30-day mortality. The functional status of survivors who had hyperthermia was much worse than those who were normothermic on Day 1. CONCLUSIONS: The severity of neurological deficit predicts greater 30-day mortality in patients with primary intracerebral hemorrhage. Patients with hyperthermia on the first day of hospitalization have greater 30-day mortality and worse functional status 30 days after stroke, but increased body temperature is not an independent predictor of 30-day mortality after PICH.
Keywords: Adult, Aged, Aged, 80 and over, Body Temperature, Cerebral Hemorrhage - mortality, Cerebral Hemorrhage - physiopathology, Data Interpretation, Statistical, Fever, Humans, Middle Aged, Prognosis, Prospective Studies, Survival Analysis, Survival Rate