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Inflammation, edema and poor outcome are associated with hyperthermia in hypertensive intracerebral hemorrhages
Author(s) -
IglesiasRey R.,
RodríguezYáñez M.,
Arias S.,
Santamaría M.,
RodríguezCastro E.,
LópezDequidt I.,
Hervella P.,
Sobrino T.,
Campos F.,
Castillo J.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13677
Subject(s) - medicine , hyperthermia , edema , intracerebral hemorrhage , etiology , anesthesia , inflammation , gastroenterology , subarachnoid hemorrhage
Background and purpose The deleterious effect of hyperthermia on intracerebral hemorrhage ( ICH ) has been studied. However, the results are not conclusive and new studies are needed to elucidate clinical factors that influence the poor outcome. The aim of this study was to identify the clinical factors (including ICH etiology) that influence the poor outcome associated with hyperthermia and ICH . We also tried to identify potential mechanisms involved in hyperthermia during ICH . Methods We conducted a retrospective study enrolling patients with non‐traumatic ICH from a prospective registry. We used logistic regression models to analyze the influence of hyperthermia in relation to different inflammatory and endothelial dysfunction markers, hematoma growth and edema volume in hypertensive and non‐hypertensive patients with ICH . Results We included 887 patients with ICH (433 hypertensive, 50 amyloid, 117 by anticoagulants and 287 with other causes). Patients with hypertensive ICH showed the highest body temperature (37.5 ± 0.8°C) as well as the maximum increase in temperature (0.9 ± 0.1°C) within the first 24 h. Patients with ICH of hypertensive etiologic origin, who presented hyperthermia, showed a 5.3‐fold higher risk of a poor outcome at 3 months. We found a positive relationship ( r = 0.717, P < 0.0001) between edema volume and hyperthermia during the first 24 h but only in patients with ICH of hypertensive etiologic origin. This relationship seems to be mediated by inflammatory markers. Conclusion Our data suggest that hyperthermia, together with inflammation and edema, is associated with poor outcome only in ICH of hypertensive etiology.