Wang Y, Lim L L, Levi C, Heller R F, Fisher J
Centre for Clinical Epidemiology and Biostatistics, Royal Newcastle Hospital, New South Wales, Australia.
Stroke. 2000 Feb;31(2):404-9. doi: 10.1161/01.str.31.2.404.
The influence of body temperature on stroke outcome remains uncertain. The aim of this study was to investigate the prognostic role of admission body temperature on short-term and long-term mortality in a retrospective cohort study of patients with acute stroke.
A retrospective cohort of 509 patients with acute stroke, admitted to a tertiary hospital between July 1, 1995, and June 30, 1997, was studied. The relationship between admission body temperature and mortality both in-hospital and at 1-year mortality was evaluated. Body temperature on admission was classified as hypothermia (</=36.5 degrees C), normothermia (>36.5 degrees C and </=37.5 degrees C), and hyperthermia (>37.5 degrees C). Logistic regression and proportional hazards function analysis were performed after adjustment for clinical predictors of stroke outcome.
In ischemic stoke, mortality was lower among patients with hypothermia and higher among patients with hyperthermia. The odds ratio for in-hospital mortality in hypothermic versus normothermic patients was 0.1 (95% CI, 0.02 to 0.5). The relative risk for 1-year mortality of hyperthermic versus normothermic patients was 3.4 (95% CI, 1.6 to 7.3). A similar but nonsignificant trend for in-hospital mortality was seen among patients with hemorrhagic stroke.
An association between admission body temperature and stroke mortality was noted independent of clinical variables of stroke severity. Hyperthermia was associated with an increase in 1-year mortality. Hypothermia was associated with a reduction in in-hospital mortality.
体温对卒中预后的影响仍不明确。本研究旨在通过一项急性卒中患者的回顾性队列研究,探讨入院时体温对短期和长期死亡率的预后作用。
对1995年7月1日至1997年6月30日期间入住一家三级医院的509例急性卒中患者进行回顾性队列研究。评估入院时体温与院内死亡率及1年死亡率之间的关系。入院时体温分为体温过低(≤36.5℃)、体温正常(>36.5℃且≤37.5℃)和体温过高(>37.5℃)。在对卒中预后的临床预测因素进行调整后,进行逻辑回归和比例风险函数分析。
在缺血性卒中患者中,体温过低者死亡率较低,体温过高者死亡率较高。体温过低患者与体温正常患者院内死亡的比值比为0.1(95%可信区间,0.02至0.5)。体温过高患者与体温正常患者1年死亡的相对风险为3.4(95%可信区间,1.6至7.3)。在出血性卒中患者中,观察到类似但无统计学意义的院内死亡趋势。
注意到入院时体温与卒中死亡率之间存在关联,且独立于卒中严重程度的临床变量。体温过高与1年死亡率增加相关。体温过低与院内死亡率降低相关。