Epidemiology and outcomes of fever burden among patients with acute ischemic stroke

Michael S. Phipps, Rani A. Desai, Charles Wira, Dawn Bravata

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background and Purpose: Although fever following ischemic stroke is common and has been associated with poor patient outcomes, little is known about which aspects of fever (eg, frequency, severity, or duration) are most associated with outcomes. Methods: We used data from a retrospective cohort of acute ischemic stroke patients who were admitted to 1 of 5 hospitals (1998-2003). A fever event was defined as a period with a temperature ≥100.0°F (37.8°C). Fever burden was defined as the maximum temperature (T max) minus 100.0°F, multiplied by the number of days with a fever. Fever burden (in degree-days) was categorized as low (0.1-2.0), medium (2.1-4.0), or high (≥4.0). Logistic regression was used to evaluate the adjusted association of any fever episode and fever burden with the combined outcome of in-hospital mortality or discharge to hospice. Results: Among 1361 stroke patients, 483 patients (35.5%) had ≥1 fever event. Among febrile patients, the median T max was 100.9°F (range, 100.0-106.6°F), 87% had ≤2 events and median total fever days was 2. Patients with any fever event had higher combined outcome rates after adjusting for demographics, stroke severity, and clinical characteristics: adjusted odds ratio (aOR), 2.7 (95% CI, 1.6-4.4). Higher fever burden was also associated with the combined outcome: high burden aOR, 6.7 (95% CI, 3.6-12.7); medium burden aOR, 3.9 (95% CI, 1.9-8.2); and low burden aOR, 1.2 (95%CI, 0.6-2.3) versus no fever. Conclusions: This study confirms that poststroke fever occurs commonly and demonstrates that patients with high fever burden have a 6-fold increased odds of death or discharge to hospice.

Original languageEnglish
Pages (from-to)3357-3362
Number of pages6
JournalStroke
Volume42
Issue number12
DOIs
StatePublished - Dec 2011

Fingerprint

Epidemiology
Fever
Stroke
Odds Ratio
Hospices
Temperature
Hospital Mortality
Logistic Models
Demography

Keywords

  • Epidemiology
  • Fever
  • Mortality
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Epidemiology and outcomes of fever burden among patients with acute ischemic stroke. / Phipps, Michael S.; Desai, Rani A.; Wira, Charles; Bravata, Dawn.

In: Stroke, Vol. 42, No. 12, 12.2011, p. 3357-3362.

Research output: Contribution to journalArticle

Phipps, Michael S. ; Desai, Rani A. ; Wira, Charles ; Bravata, Dawn. / Epidemiology and outcomes of fever burden among patients with acute ischemic stroke. In: Stroke. 2011 ; Vol. 42, No. 12. pp. 3357-3362.
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