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Body temperature and major neurological improvement in tPA ‐treated stroke patients
Author(s) -
Kvistad C. E.,
Thomassen L.,
WajeAndreassen U.,
Logallo N.,
Naess H.
Publication year - 2014
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12184
Subject(s) - medicine , stroke (engine) , ischaemic stroke , cardiology , neuroprotection , anesthesia , ischemia , mechanical engineering , engineering
Background Major neurological improvement ( MNI ) at 24 hours represents a marker of early recanalization in ischaemic stroke. Although low body temperature is considered neuroprotective in cerebral ischaemia, some studies have suggested that higher body temperature may promote clot lysis in the acute phase of ischaemic stroke. We hypothesized that higher body temperature was associated with MNI in severe stroke patients treated with t PA , suggesting a beneficial effect of higher body temperature on clot lysis and recanalization. Methods Patients with ischaemic stroke or transient ischaemic attack ( TIA ) treated with t PA between F ebruary 2006 and A ugust 2012 were prospectively included and retrospectively analysed. Body temperature was measured upon admission. MNI was defined by a ≥8 point improvement in NIHSS score at 24 hours as compared to NIHSS score on admission. No significant improvement (no‐ MNI ) was defined by either an increase in NIHSS score or a decrease of ≤2 points at 24 hours in patients with an admission NIHSS score of ≥8. Results Of the 2351 patients admitted with ischaemic stroke or TIA, 347 patients (14.8%) were treated with t PA . A total of 32 patients (9.2%) had MNI and 56 patients (16.1%) had no‐ MNI . Patients with MNI had higher body temperatures compared with patients with no‐MNI (36.7°C vs 36.3°C, P = 0.004). Higher body temperature was independently associated with MNI when adjusted for confounders (OR 5.16, P = 0.003). Conclusion Higher body temperature was independently associated with MNI in severe ischaemic stroke patients treated with t PA . This may suggest a beneficial effect of higher body temperature on clot lysis and recanalization.