MedWire News: Hyperthermia is associated with poor clinical outcomes in patients with acute ischemic stroke and should be managed aggressively, researchers believe.
The findings are reported by an international team, the Virtual International Stroke Trial Archive (VISTA) investigators, who studied the effect of body temperature on ischemic stroke outcomes.
Ashfaq Shuaib (University of Alberta, Canada) and team analyzed data on 5305 patients who had participated in acute stroke trials. The patients’ average age was 68.0 years, 44.9% were female, and 42.3% received thrombolysis with recombinant tissue plasminogen activator.
The study, which is reported in the journal Stroke, revealed that hyperthermia (defined as a temperature >37.2°C) was a statistically significant predictor of poor outcomes (defined as a score >2 on the modified Rankin Scale at 90 days post-stroke). This remained true after adjusting for other prognostic factors.
Interestingly, the impact of hyperthermia varied over time, such that the later the hyperthermia occurred within the first week post-stroke, the worse the prognosis. For instance, the hazard ratio for a poor outcome rose from 1.2 when hyperthermia was present on admission to 2.7 when present on day 7.
Several clinical characteristics were significantly associated with hyperthermia, the authors remark. These included gender, stroke severity, white blood cell count, and use of antibiotics.
Shuaib et al say that their analysis confirms a correlation between hyperthermia and poor outcomes following acute ischemic stroke and suggests, for the first time, that delayed hyperthermia has a more deleterious impact on outcomes than hyperthermia occurring in the early hours.
This “suggests that a wide window of opportunity is available for prevention of hyperthermia or its cause(s),” they write.
“Aggressive steps to prevent and treat hyperthermia should be a part of management protocols for improving clinical outcomes after ischemic stroke.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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