Factors Associated with Fever in Intracerebral Hemorrhage
Background Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. Methods A retrospective review on consecutive spontaneous ICH patients from April 2009 to Ma...
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| Veröffentlicht in: | Journal of stroke and cerebrovascular diseases 2017-06, Vol.26 (6), p.1204-1208 |
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| creator | Gillow, Sabreena J., MD Ouyang, Bichun, PhD Lee, Vivien H., MD John, Sayona, MD |
| description | Background Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. Methods A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection. Results Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P |
| doi_str_mv | 10.1016/j.jstrokecerebrovasdis.2017.01.007 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1867539140</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1052305717300216</els_id><sourcerecordid>1867539140</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-e8118409ce9c5276cbb7914b55ca7cd343dbaf6ca611044522323f9f80e0c45f3</originalsourceid><addsrcrecordid>eNqVkcFu1DAQhi0EoqXwCihHhJQwY8dxckEqFUsrrcQBOFuOM6FOs3HxZBf17fFqCwfEhdPM4df3a74R4i1ChYDNu6maeE3xjjwl6lM8OB4CVxLQVIAVgHkizlErWbYa8WneQctSgTZn4gXzBICoW_1cnMkWW9N18lx0G-fXmLi4ZI4-uJWG4mdYb4sNHSgVYSluljW5U6Obi2vaxZRu3Xd6KZ6NbmZ69TgvxLfNx69X1-X286ebq8tt6WvdrSW1iG0NnafOa2ka3_emw7rX2jvjB1WroXdj412DCHWtpVRSjd3YAkEmjOpCvDlx71P8sSde7S6wp3l2C8U9W2wbo1VGQo5-OEV9isyJRnufws6lB4tgjwrtZP-l0B4VWkCbFWbI68e-fb-j4Q_it7Mc2J4ClK8-BEqWfaDF0xAS-dUOMfxf3_u_cH4OS_BuvqMH4inu05L9WrQsLdgvx6cef4pGAUhs1C_jcaTq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1867539140</pqid></control><display><type>article</type><title>Factors Associated with Fever in Intracerebral Hemorrhage</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Gillow, Sabreena J., MD ; Ouyang, Bichun, PhD ; Lee, Vivien H., MD ; John, Sayona, MD</creator><creatorcontrib>Gillow, Sabreena J., MD ; Ouyang, Bichun, PhD ; Lee, Vivien H., MD ; John, Sayona, MD</creatorcontrib><description>Background Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. Methods A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection. Results Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P < .0001), and surgical evacuation (OR = 6.78, P < .0001) were significant predictors of fever. Infectious fever (OR = 5.26, P = .004), EVD (OR = 4.86, P = .01), and surgical evacuation (OR = 4.77, P = .04) correlated with prolonged LOS when dichotomized using a median of 15 days. Conclusions Fever is common in ICH patients and is not associated with a clear infectious etiology in the majority of patients. Patients with noninfectious fever have higher in-hospital mortality, but survivors have shorter LOS. Further studies are warranted to better understand fevers in ICH.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2017.01.007</identifier><identifier>PMID: 28187992</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Body Temperature Regulation ; Cardiovascular ; central fever ; Cerebral Hemorrhage - complications ; Cerebral Hemorrhage - mortality ; Cerebral Hemorrhage - therapy ; Chi-Square Distribution ; Female ; Fever ; Fever - etiology ; Fever - mortality ; Fever - physiopathology ; Fever - therapy ; Hospital Mortality ; Humans ; intracerebral hemorrhage ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Neurology ; noninfectious fever ; Odds Ratio ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2017-06, Vol.26 (6), p.1204-1208</ispartof><rights>National Stroke Association</rights><rights>2017 National Stroke Association</rights><rights>Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-e8118409ce9c5276cbb7914b55ca7cd343dbaf6ca611044522323f9f80e0c45f3</citedby><cites>FETCH-LOGICAL-c459t-e8118409ce9c5276cbb7914b55ca7cd343dbaf6ca611044522323f9f80e0c45f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1052305717300216$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28187992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gillow, Sabreena J., MD</creatorcontrib><creatorcontrib>Ouyang, Bichun, PhD</creatorcontrib><creatorcontrib>Lee, Vivien H., MD</creatorcontrib><creatorcontrib>John, Sayona, MD</creatorcontrib><title>Factors Associated with Fever in Intracerebral Hemorrhage</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. Methods A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection. Results Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P < .0001), and surgical evacuation (OR = 6.78, P < .0001) were significant predictors of fever. Infectious fever (OR = 5.26, P = .004), EVD (OR = 4.86, P = .01), and surgical evacuation (OR = 4.77, P = .04) correlated with prolonged LOS when dichotomized using a median of 15 days. Conclusions Fever is common in ICH patients and is not associated with a clear infectious etiology in the majority of patients. Patients with noninfectious fever have higher in-hospital mortality, but survivors have shorter LOS. Further studies are warranted to better understand fevers in ICH.</description><subject>Body Temperature Regulation</subject><subject>Cardiovascular</subject><subject>central fever</subject><subject>Cerebral Hemorrhage - complications</subject><subject>Cerebral Hemorrhage - mortality</subject><subject>Cerebral Hemorrhage - therapy</subject><subject>Chi-Square Distribution</subject><subject>Female</subject><subject>Fever</subject><subject>Fever - etiology</subject><subject>Fever - mortality</subject><subject>Fever - physiopathology</subject><subject>Fever - therapy</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>intracerebral hemorrhage</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neurology</subject><subject>noninfectious fever</subject><subject>Odds Ratio</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkcFu1DAQhi0EoqXwCihHhJQwY8dxckEqFUsrrcQBOFuOM6FOs3HxZBf17fFqCwfEhdPM4df3a74R4i1ChYDNu6maeE3xjjwl6lM8OB4CVxLQVIAVgHkizlErWbYa8WneQctSgTZn4gXzBICoW_1cnMkWW9N18lx0G-fXmLi4ZI4-uJWG4mdYb4sNHSgVYSluljW5U6Obi2vaxZRu3Xd6KZ6NbmZ69TgvxLfNx69X1-X286ebq8tt6WvdrSW1iG0NnafOa2ka3_emw7rX2jvjB1WroXdj412DCHWtpVRSjd3YAkEmjOpCvDlx71P8sSde7S6wp3l2C8U9W2wbo1VGQo5-OEV9isyJRnufws6lB4tgjwrtZP-l0B4VWkCbFWbI68e-fb-j4Q_it7Mc2J4ClK8-BEqWfaDF0xAS-dUOMfxf3_u_cH4OS_BuvqMH4inu05L9WrQsLdgvx6cef4pGAUhs1C_jcaTq</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Gillow, Sabreena J., MD</creator><creator>Ouyang, Bichun, PhD</creator><creator>Lee, Vivien H., MD</creator><creator>John, Sayona, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Factors Associated with Fever in Intracerebral Hemorrhage</title><author>Gillow, Sabreena J., MD ; Ouyang, Bichun, PhD ; Lee, Vivien H., MD ; John, Sayona, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-e8118409ce9c5276cbb7914b55ca7cd343dbaf6ca611044522323f9f80e0c45f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Body Temperature Regulation</topic><topic>Cardiovascular</topic><topic>central fever</topic><topic>Cerebral Hemorrhage - complications</topic><topic>Cerebral Hemorrhage - mortality</topic><topic>Cerebral Hemorrhage - therapy</topic><topic>Chi-Square Distribution</topic><topic>Female</topic><topic>Fever</topic><topic>Fever - etiology</topic><topic>Fever - mortality</topic><topic>Fever - physiopathology</topic><topic>Fever - therapy</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>intracerebral hemorrhage</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neurology</topic><topic>noninfectious fever</topic><topic>Odds Ratio</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gillow, Sabreena J., MD</creatorcontrib><creatorcontrib>Ouyang, Bichun, PhD</creatorcontrib><creatorcontrib>Lee, Vivien H., MD</creatorcontrib><creatorcontrib>John, Sayona, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gillow, Sabreena J., MD</au><au>Ouyang, Bichun, PhD</au><au>Lee, Vivien H., MD</au><au>John, Sayona, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Associated with Fever in Intracerebral Hemorrhage</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>26</volume><issue>6</issue><spage>1204</spage><epage>1208</epage><pages>1204-1208</pages><issn>1052-3057</issn><eissn>1532-8511</eissn><abstract>Background Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. Methods A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection. Results Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P < .0001), and surgical evacuation (OR = 6.78, P < .0001) were significant predictors of fever. Infectious fever (OR = 5.26, P = .004), EVD (OR = 4.86, P = .01), and surgical evacuation (OR = 4.77, P = .04) correlated with prolonged LOS when dichotomized using a median of 15 days. Conclusions Fever is common in ICH patients and is not associated with a clear infectious etiology in the majority of patients. Patients with noninfectious fever have higher in-hospital mortality, but survivors have shorter LOS. Further studies are warranted to better understand fevers in ICH.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28187992</pmid><doi>10.1016/j.jstrokecerebrovasdis.2017.01.007</doi><tpages>5</tpages></addata></record> |
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| subjects | Body Temperature Regulation Cardiovascular central fever Cerebral Hemorrhage - complications Cerebral Hemorrhage - mortality Cerebral Hemorrhage - therapy Chi-Square Distribution Female Fever Fever - etiology Fever - mortality Fever - physiopathology Fever - therapy Hospital Mortality Humans intracerebral hemorrhage Length of Stay Logistic Models Male Middle Aged Multivariate Analysis Neurology noninfectious fever Odds Ratio Prognosis Retrospective Studies Risk Assessment Risk Factors Time Factors |
| title | Factors Associated with Fever in Intracerebral Hemorrhage |
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