Fever in Acute Stroke Worsens Prognosis

Azzimondi, G; Bassein, Leona; Nonino, Francesco; Fiorani, L; Vignatelli, Luca; Re, Giuseppe; D’Alessandro, Roberto

doi:10.1161/01.str.26.11.2040

Cited by 376 publications

(154 citation statements)

References 10 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…In contradiction to the report of Davenport et al [16] gastrointestinal bleeding was not a bad prognostic factor. We confirm that fever, even without detected infection, is associated with bad prognosis [17, 18]. …”

Section: Discussionsupporting

confidence: 79%

Can a Clinical Classification of Stroke Predict Complications and Treatments during Hospitalization?

et al. 1998

View full text Add to dashboard Cite

The predictive value of the Oxfordshire Community Stroke Project ischemic stroke classification for acute stroke complications, therapeutic interventions and disability at discharge was investigated in 297 consecutive first-ever acute stroke patients. More than one medical complication (odds ratio, OR = 2.2), fever (OR = 2.5) and dependency (Rankin grade >2) at discharge (OR = 2.3) were more frequent in intracerebral hemorrhage patients. Fever and urinary tract infections were the most common complications among ischemic stroke patients. Both were more frequent in total anterior circulation infarct (TACI) patients (OR = 11.5 and OR = 3.7). Neurological deterioration was observed in about 10% of TACI and posterior circulation infarct (POCI) patients. Dependency at discharge was more frequent in TACI patients (OR = 10.3). Logistic regression analysis identified ischemic stroke subgroups (OR = 8.4) and medical complications (OR = 3.8) as predictors of poor outcome (Rankin score ≥4). A clinical classification is useful to predict possible medical and neurological complications in the acute phase, death and dependency at discharge.

show abstract

Section: Discussionsupporting

confidence: 79%

Can a Clinical Classification of Stroke Predict Complications and Treatments during Hospitalization?

et al. 1998

View full text Add to dashboard Cite

show abstract

“…There are a number of possible underlying factors for incontinence following acute stroke but it can be argued that this is largely an age-related phenomenon since we did not find any difference in stroke pathology on CT scan and stroke severity between the two age groups although there is a significant difference in the incidence of incontinence between the younger and older patients. Pyrexia in acute stroke phase is known to worsen prognosis [16, 17]. In our study the older stroke patients were no more prone to develop elevated temperature and thus pyrexia would not account for their poor outcome.…”

Section: Discussionmentioning

confidence: 55%

“…Patients with severe stroke syndromes as defined on the Oxfordshire Community Stroke Project (OCSP) [13], larger cerebral infarcts on computerised tomography (CT) scans [14, 15]development of pyrexia [16, 17]and presence of dysphagia [18, 19]have a higher mortality and disability.…”

Section: Introductionmentioning

confidence: 99%

Strokes in the Elderly – Higher Acute and 3-Month Mortality – An Explanation

Sharma

Fletcher

Vassallo³

1999

Cerebrovasc Dis

View full text Add to dashboard Cite

Aim: Stroke is common in older people. The objective of the study was to determine if older stroke patients have a higher mortality and disability compared with younger patients for comparable stroke severity and pathology and whether there is an explanation for the difference. Methods: A prospective study was undertaken in 296 consecutive patients admitted with acute stroke. Patients were studied for neurological features, pre-stroke functional disability, severity of stroke defined by stroke syndromes and pathology of stroke on CT scans (202 patients). Post-stroke disability was defined according to the functional status within 72 h of admission. A record was made of the intercurrent illness while the patients were in acute wards and of the risk factors. Patients were dichotomised into two age groups: younger group – up to 75 years (163 patients) and older group – over 75 years (133 patients). Outcome was measured according to (1) discharge status from acute wards, i.e., dead or alive, and (2) mortality at 3 months. Results: Although there was no significant difference in severe clinical stroke syndromes (p = 0.72), CT scan features (p = 0.68) and pyrexia (0.38) between the two age groups, the older patients had significantly more disabling strokes as defined on Barthel Index (p = 0.015) and a higher mortality in the acute phase (p < 0.01) and at 3 months (p = 0.001). The older stroke patients had more severe pre-stroke disability (p < 0.001) and more severe neurological impairment for similar stroke severity and pathology. Early mortality was more influenced by pre-stroke global health than age whereas 3-month mortality was influenced by age to the exclusion of all other known prognostic factors. Conclusion: The older stroke patients have more disabling stroke and an increased mortality for a similar spectrum of stroke severity and pathology. The explanation for higher mortality of the older patients is the poor pre-stroke health and higher immediate post-stroke disability.

show abstract

“…Between 22 and 43% of patients develop fever or subfebrile temperatures during the first days after stroke [78, 79, 80]. In most cases, pulmonary or uninary tract infection are the cause of hyperthermia [78, 81].…”

Section: Systemic Complicationsmentioning

confidence: 99%

“…Fever is more common in patients with larger infarcts [78]. Subfebrile temperatures and fever in the first days after stroke are associated with an increased case fatality and poor functional outcome [79, 80, 81], but a threshold above which hyperthermia is detrimental has not been established. There are no controlled studies about the efficacy of reducing temperature after stroke, but at least the source of fever should be determined and treated, and it may be useful to treat hyperthermia with antipyretics.…”

Section: Systemic Complicationsmentioning

confidence: 99%

Complications of Acute Ischaemic Stroke

Worp¹,

Kappelle²

1998

Cerebrovasc Dis

View full text Add to dashboard Cite

Neurological, cardiac, and systemic complications during the first days to weeks after ischaemic stroke can cause substantial morbidity and mortality. The reported 30-day case fatality rate for cerebral infarction varies between 10 and 17%. The incidence and effects of the various complications vary with time after stroke: transtentorial herniation and other cerebral complications prevail during the 1st week, whereas medical complications are more prominent in the weeks thereafter. Many complications are treatable, and some are preventable. The goal of this report is to provide information on their incidence, consequences, and management.

show abstract

Fever in Acute Stroke Worsens Prognosis

Cited by 376 publications

References 10 publications

Can a Clinical Classification of Stroke Predict Complications and Treatments during Hospitalization?

Can a Clinical Classification of Stroke Predict Complications and Treatments during Hospitalization?

Strokes in the Elderly – Higher Acute and 3-Month Mortality – An Explanation

Complications of Acute Ischaemic Stroke

Contact Info

Product

Resources

About