Premium
Body temperature and response to thrombolytic therapy in acute ischaemic stroke
Author(s) -
Millán M.,
Grau L.,
Castellanos M.,
RodríguezYáñez M.,
Arenillas J. F.,
Nombela F.,
Pérez de la Ossa N.,
LópezManzanares L.,
Serena J.,
Castillo J.,
Dávalos A.
Publication year - 2008
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/j.1468-1331.2008.02321.x
Subject(s) - medicine , modified rankin scale , tissue plasminogen activator , stroke (engine) , odds ratio , transcranial doppler , fibrinolytic agent , acute stroke , cardiology , thrombolysis , ischemic stroke , ischemia , myocardial infarction , mechanical engineering , engineering
Objective: To determine the relationship between body temperature (BT), arterial recanalization, functional outcome, and hemorrhagic transformation (HT) of cerebral infarction in patients treated with i.v. tissue plasminogen activator (tPA). Methods: We studied 254 patients treated with tPA within 3 h from stroke onset. National Institute of Health Stroke Scale score, BT, and transcranial Doppler ultrasound ( n = 99) on admission and at 24 h were recorded. Hypodensity volume and HT were evaluated on CT at 24–36 h. Poor outcome (Rankin Scale > 2) was evaluated at 3 months. Results: Arterial recanalization at 24 h was found in 70.7% of patients, HT in 24.8% (symptomatic in 4.7%) and poor outcome in 44.1%. Baseline BT was not associated with greater stroke severity at admission or at 24 h, HT or poor outcome. However, BT at 24 h correlated to stroke severity ( P < 0.001) and hypodensity volume ( P < 0.001) at 24 h, and was higher in patients who did not recanalize ( P = 0.001), had symptomatic HT ( P = 0.063) and poor outcome ( P < 0.001). The adjusted odds ratio of poor outcome for patients with BT at 24 h ≥ 37°C was 2.56 (1.19–5.50, P = 0.016). Conclusion: Body temperature ≥37°C at 24 h, but not at baseline, is associated with a lack of recanalization, greater hypodensity volume and worse outcome in stroke patients treated with tPA.