Effects of Poststroke Pyrexia on Stroke Outcome

作者：Cother Hajat, Shakoor Hajat, Pankaj Sharma · 发表于：Stroke · 年份：2000 · DOI：10.1161/01.str.31.2.410 · 被引用次数：428 · 研究领域：Thermal Regulation in Medicine、Hematological disorders and diagnostics、Malaria Research and Control

BACKGROUND AND PURPOSE: The effect of pyrexia on cerebral ischemia has been extensively studied in animals. In humans, however, such studies are small and the results conflicting. We undertook a meta-analysis using all such published studies on the effect of hyperthermia on stroke outcome. METHODS: Three databases were searched for all published studies that examined the relationship of raised temperature after stroke onset and eventual outcome. Combined probability values and odds ratios were obtained. A heterogeneity test was performed to ensure that the data were suitable for such an analysis. Morbidity and mortality were used as outcome measures. RESULTS: Nine studies were identified totaling 3790 patients, providing our study with 99% power to detect a 9% increase in morbidity and 84% power to detect a 1% increase in mortality for the pyrexial group. The combined odds ratio for mortality was 1.19 (95% CI, 0.99 to 1.43). A heterogeneity test was highly nonsignificant (P>0.05) for mortality, suggesting that the data were sufficiently similar to be meta-analyzed. Combined probability values were highly significant for both morbidity (P<0.0001) and mortality (P<0. 00000001). CONCLUSIONS: The results from this meta-analysis suggest that pyrexia after stroke onset is associated with a marked increase in morbidity and mortality. Measures should be taken to combat fever in the clinical setting to prevent stroke progression. The possible benefit of therapeutic hypothermia in the ...