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Relationship Between Body Temperature and Early Neurological Deterioration after Endovascular Thrombectomy for Acute Ischemic Stroke with Large Vessel Occlusion

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A Correction to this article was published on 05 March 2022

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Abstract

Background

Early neurological deterioration (END) after endovascular thrombectomy (EVT) is strongly associated with poor prognosis in patients with large vessel occlusion. The relationship between body temperature and END after EVT is unknown, which we aimed to investigate in this study.

Methods

END was defined as an increase of four or more points on the National Institutes of Health Stroke Scale score compared with the baseline assessment within 24 h. Logistic regression and restricted cubic spline models were used to assess the relationship between body temperature and END.

Results

Among 7741 consecutive patients with ischemic stroke, 406 patients with large vessel occlusion who underwent EVT were enrolled. In total, 88 (21.7%) patients developed END. Logistic regression showed that the maximum body temperature within 24 h (odds ratio [OR] = 1.97 per °C, 95% confidence interval [CI] 1.17–3.32, p = 0.010) was independently associated with END. This association was nonlinear and J shaped (p for nonlinearity = 0.010), and the risk of END increased when the maximum body temperature within 24 h was lower or higher than 37.0 °C. Fever burden is also independently associated with END (OR = 1.06 per °C  × hour, 95% CI 1.01–1.11, p = 0.012). In addition, the timing of fever onset was independently associated with END, and the highest risk of END was associated with fever onset within 6 h after EVT (OR = 3.92, 95% CI 1.25–12.27, p = 0.019).

Conclusions

In summary, there is a J-shaped association between the maximum body temperature within 24 h after EVT and END. Moreover, the risk of END differed according to the timing of fever onset.

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Data availability

The data that support the findings of this study are available from the corresponding author on reasonable request.

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Acknowledgement

We thank Professor Cairong Zhu from the School of Public Health SCU, who kindly assisted with the design of the statistical method for our analysis.

Funding

This work was supported by the National Key Research and Development Program of China (Nos. 2018YFC1311400, 2018YFC1311401), the National Natural Science Foundation of China (Grant No. 81772435), the Science & Technology Department of Sichuan Province (No. 2020YFS0155), and West China Nursing Discipline Special Fund Project, Sichuan University (HXHL20021).

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Author notes

  1. YL and MC contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, China

    Yaxi Luo, Man Chen, Jinghuan Fang, Shuju Dong, Mengmeng Ma, Jiajia Bao, Ling Feng & Li He

  2. West China School of Nursing, Sichuan University, Chengdu, China

    Ling Feng

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Contributions

Study conception and design: LH, YL, and MC. Data acquisition: YL, MC, JB, LF. Data analysis and interpretation: YL, MC, SD, JB. Statistical analysis: YL, SD. Article draft: YL, JF, SD, MM. Critical revision of the manuscript for important intellectual content: LH, LF, YL, MC, JF, SD, MM, JB. Approved the submitted version: LH, LF, YL, MC, JF, SD, MM, JB.

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Correspondence to Ling Feng or Li He.

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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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The authors confirm adherence to ethical guidelines and indicate ethical approvals (institutional review board). This study was performed in accordance with ethics principles of the 1964 Declaration of Helsinki and its later amendments and approved by the Ethics Committee of West China Hospital. The need to obtain informed consent was waived because of the retrospective and observational nature of the study.

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Supplemental Fig. 1 Schematic of fever burden.

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Luo, Y., Chen, M., Fang, J. et al. Relationship Between Body Temperature and Early Neurological Deterioration after Endovascular Thrombectomy for Acute Ischemic Stroke with Large Vessel Occlusion. Neurocrit Care 37, 399–409 (2022). https://doi.org/10.1007/s12028-021-01416-9

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