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- W2895838303 abstract "Introduction: Fever following acute ischemic stroke (AIS) promotes greater consumption of ischemic penumbra despite reperfusion; however, the influence of timing of onset and duration of fever remains unexplored. We assessed the impact of such temporal features on infarct growth and clinical outcome in AIS, hypothesizing a dose-dependent negative response to sustained fever. Methods: Retrospective study of AIS patients presenting with proximal large vessel occlusion within 12h of onset, and achieving reperfusion (mTICI 2b/3). Pretreatment CTP was obtained in all subjects in a fully automated environment (RAPID) for segmentation of ischemic core and penumbral mismatch volumes. Final infarct volumes (FIV) were measured by DWI, and relative infarct growth (RIG) computed as (FIV-CTPcore/CTPmismatch). Systemic temperatures were obtained up to q15 minutes from presentation to DWI. Fever (>37.5) onset and duration were documented. Pearson’s correlation and linear and logistic regressions tested the association of fever onset and duration vs. RIG and favorable clinical outcome (90d mRS≤2). Results: 119 subjects (59 men, age 63±14 yrs) met inclusion. Median[IQR] NIHSS=18[8]; last known well to groin puncture=355min[310]; median[IQR] core, mismatch, and FIV=9.6[23.8], 109[104], and 19.6[37]ml, respectively. Median fever duration=9h. Fever duration and time to onset were not independently associated with RIG (p=0.4, 0.6). The best fit model for prediction of RIG included fever, procedure duration and initial core. The OR for 90d mRS≤2 in febrile patients controlling for fever onset, age, NIHSS, core and procedure parameters was 0.6 (0.14-2.85). The adjusted OR for 90d mRS≤2 given one additional hour of febrile time was non-significant (0.99, 0.9-1.0). Earlier timing of fever onset was independently correlated to clinical outcome (p=0.04). Conclusions: While fever promotes infarct growth despite reperfusion, these findings suggest duration of fever is less influential upon imaging and clinical outcomes than hypothesized, with the negative impact of fever in the early aftermath of AIS driving worse outcomes irrespective of duration. The findings underscore the importance of temperature control during early temperature dysregulation after AIS." @default.
- W2895838303 created "2018-10-26" @default.
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- W2895838303 date "2018-01-22" @default.
- W2895838303 modified "2023-09-27" @default.
- W2895838303 title "Abstract WP326: Fever Promotes Worse Outcomes in Reperfused Patients Irrespective of Febrile Duration" @default.
- W2895838303 doi "https://doi.org/10.1161/str.49.suppl_1.wp326" @default.
- W2895838303 hasPublicationYear "2018" @default.
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