Effects Of Temperature On Acute Stroke Outcome: A Prospective Clinical Study

Backgroud and purpose: The association between admission temperature and stroke outcome has been established in clinical. However, it was not been known whether the temperature of after 24 hours of stroke onset still influenced on stroke prognosis. The aim of this study was to determine the prognostic value of bady tumperature during several days after 24 hours of stroke onset . Methods: This prospective study included 104 consecutive patients,57 cerebral infarcts and 47 with intracerebral hemorrhages, within 24 hours of stroke onset. Axillary temperature was measured on admission and every 4 hours during first 7 days after stroke onset. Admission temperature, the mean temperature of 72 hours and 7 days was recorded as the temperature of three different terms and analyzed. Stroke severity was quantified with National Institute Healthy Stroke Scale(NIHSS) on admission. Some potiential factor which may influence on stroke outcome was recorded too. Cox proportional hazards function analysis and Logistic regression were performed to evaluate the association between the temperature of different terms and outcome (survival and Acitivies DailyLiving at 1 month). Results: 16 patients(15.4%) had fever at admission.Patient with hyperthermia had more severe stroke at admission. In the most stroke patients, body temperture rised after 24 hours of stroke onset. The admission body temperture was not an independent predictor of outcome(Survival and ADL at 1 month),But the mean body temperature of 72 hours or 7 days after stroke onset was an independent predictor ofoutcome(Survival at 1 month),with a 1 C increase of temperature predictinga 47.3% or 46.1% relative increase (95%CI 1.07 to 2.01 p=0.015 and 1.1 to 1.94 p=0.009) in mortality risk.The mean temperature of 7 days after stroke onset was an independent risk factor of poor ADL at 1 month (OR=0.129, 95% CI=0.022 to 0.755 p=0.023). Conclusions: Admission body had no prognostic influence on stroke outcome at 1 month, but the mean body temperature of 72 hours and 7 days after stroke onset was an independent predictor of survival at 1 month. The mean body temperature of 7 days was an independent risk factor of poor ADL at 1 month too. The prolonged hyperthermia after stroke may influence on clinical outcome. We suggest that temperature of the first several days after stroke onset be maintained in a safe normothermic range.