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Fever Burden and Health-Related Quality of Life After Intracerebral Hemorrhage

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Abstract

Background

Fever is associated with worse functional outcomes after intracerebral hemorrhage (ICH); however, there are few prospective data to quantify the relationship with health-related quality of life (HRQoL). We tested the hypothesis that increased burden of fever is independently associated with decreased HRQoL at follow-up.

Methods

In this prospective observational cohort study of 106 ICH patients admitted to a tertiary care hospital between 2011 and 2015, we recorded the highest core temperature each calendar day for 14 days after ICH onset. Fever burden was defined as the number of days with a fever ≥ 100.4 °F (38 °C). HRQoL outcomes were measured with Neuro-QoL domains of Cognitive Function and Mobility at 28 days, 3 months, and 1 year. Results were analyzed using mixed effects regression analysis.

Results

Each additional day with a fever was independently associated with lower Mobility HRQoL (T-score − 0.9, [− 1.6 to − 0.2]; p = 0.01) and Cognitive Function HRQoL (T-score − 1.3 [− 2.0 to − 0.6]; p = 0.001) after correction for National Institutes of Health Stroke Scale score on admission, age, and time to follow-up.

Conclusions

Each additional day with a fever was predictive of worse HRQoL domains of Cognitive Function and Mobility after ICH up to 1 year. These data extend previous evidence on the negative association of fever and functional outcomes to the domains of Cognitive Function and Mobility HRQoL. HRQoL outcomes may be a sensitive and powerful way to measure the efficacy of fever control in future research.

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Funding

This work was supported in part by a research grant to Dr. Naidech (HS023437) from the Agency for Healthcare Research and Quality (AHRQ). Opinions expressed do not necessarily reflect the viewpoint of AHRQ. Dr. Liotta receives support from the National Institutes of Health National Center for Advancing Translational Sciences Grant Number KL2TR001424 and the National Institute of Health Grant Number L30 NS098427. Dr. Maas received funding from the National Institutes of Health Grants K23NS092975 and L30 NS080176. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Neurology, Northwestern University, 710 N Lake Shore Drive, 11th Floor, Chicago, IL, 60611, USA

    Robin A. Bush, Eric M. Liotta, Matthew B. Maas & Andrew M. Naidech

  2. Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA

    Jennifer L. Beaumont

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  1. Robin A. Bush
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Correspondence to Robin A. Bush.

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Robin A. Bush and Jennifer L. Beaumont have disclosed that they do not have any potential conflicts of interest. Eric M. Liotta, Matthew B. Maas, and Andrew M. Naidech have disclosed that they do not have any potential conflicts of interest apart from the information provided, see funding.

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Bush, R.A., Beaumont, J.L., Liotta, E.M. et al. Fever Burden and Health-Related Quality of Life After Intracerebral Hemorrhage. Neurocrit Care 29, 189–194 (2018). https://doi.org/10.1007/s12028-018-0523-y

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