The time course and determinants of temperature within the first 48 h after ischaemic stroke

Abstract

Background and Purpose: Previous research has attempted to analyze the relationship between post-stroke hyperthermia and prognosis. These analyses have been hindered by a lack of information about the time course and determinants of temperature change after stroke. Methods: Serial temperatures were measured until 48 h after ischaemic stroke in a prospectively recruited cohort. Potential determinants of temperature, including stroke severity [measured using the National Institutes of Health Stroke Scale (NIHSS)], infection and paracetamol use were recorded. Mixed-effects models were used to model serial temperature measurements over time, adjusted for significant determinants. Results: In 155 patients the mean temperature rose from 36.5°C at the time of stroke to 36.7°C approximately 36 h later. The factors with significant multivariable associations with serial temperatures were: first- and second-order time components, infection, paracetamol administration and the interaction between stroke severity (NIHSS ≥6) and time (all p < 0.1). Patients with admission NIHSS ≥6 had a mean temperature rise of 0.35°C during the first 36 h after stroke, compared with a rise of 0.17°C in those with NIHSS ≤5. Conclusions: Temperature spontaneously rises during the first 36 h after stroke, particularly after severer stroke and in the presence of infection. Copyright © 2007 S. Karger AG.