Abstract 3658: Early and Late Predictors of Hyperthermia after Spontaneous ICH: on behalf of VISTA Collaborators
Introduction. Hyperthermia is an independent predictor of poor outcome after stroke. We sought to determine early predictors of hyperthermia after spontaneous ICH.
Methods. Data of patients from acute ICH trials registered in the Virtual International Stroke Trials Archive (VISTA-ICH) were analyzed. Admission variables were assessed in relation to the recorded temperatures at baseline, 24hr, 48hr, 72hr and 7-days, using linear regression based on the normal distribution of the dependent variables. Models were fitted and odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Results. In total, 303 patients were included in the analysis. The average age of the cohort was 66 ± 12 years, 200 (66%) were males, the median admission NIHSS was 13 (Interquartile range [IQR], 9-18), median GCS was 15 (IQR, 14-15), mean temperature was 36.4 ± 0.5 °C at baseline; 36.7 ± 0.6 °C at 24hr; 37.1 ± 0.7 °C at 48hr; 36.9 ± 0.6 °C at 72hr, and 36.8 ± 0.6 °C at 7-days. The median hematoma volume at baseline CT scan was 15cc (IQR, 8-33), intraventricular hemorrhage (IVH) was present in 104 (34%) of patients, and hematoma growth >33% occurred in 50 patients (34%, n=185). Variables associated with higher temperature were: admission NIHSS >13, IVH, infratentorial origin or location, volume of hematoma growth, hematoma growth >33%, and the following additional components of ICH score: base volume >30ml, and Glasgow Coma Scale (GCS) <13. After adjustment, ICH baseline volume >30cc (OR, 1.2; 95%CI, 1.1-1.3) and hematoma growth >33% (OR, 1.1; 95%CI, 1.01-1.2) (Baseline intercept = 37.2 C) were associated with hyperthermia at 24hrs; and hematoma growth >33% (OR, 1.1; 95%CI, 1.02-1.2) and IVH (OR, 1.1; 95%CI, 1.02-1.2) (Baseline intercept = 37.1 C) were associated with higher temperature at 7-days.
Conclusions. These data suggests that in ICH patients, hematoma baseline volume >30cc and hematoma growth are independently associated with higher temperature at 24 hrs and hematoma growth and IVH with higher temperature at 7 days. Prevention of hematoma growth and treatment of IVH may decrease the prevalence of hyperthermia in these patients.
- © 2012 by American Heart Association, Inc.