Chen Man, Fang Jinghuan, Wu Xintong, Liu Qin, Feng Ling, He Li
Department of Neurology, West China Hospital, Sichuan University, 610041, Chengdu, China.
Department of Neurology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, 610041, Chengdu, China.
BMC Neurol. 2021 Sep 21;21(1):365. doi: 10.1186/s12883-021-02400-8.
Limited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization. We aimed to explore the prognostic value of BT in predicting outcomes of stroke recovery at 3 months poststroke.
We retrospectively analyzed the relationship among BT levels as a continuous variable, with fever (BT ≥ 37.5℃) as a binary variable, and obtained several outcomes of interest. Subjects were stratified according to successful recanalization (thrombolysis in cerebral infarction scores of 2b-3) following MT. Functional independence was defined as a modified Rankin scale (mRS) score of 0-2.
In total, 258 patients were included. The proportion of patients with functional independence was significantly lower among patients with BT ≥ 37.5℃ than among those with BT < 37.5 °C (45.3 % versus 23.0 %; P < 0.001). In the multivariate analysis, hyperpyrexia (especially BT ≥ 38 °C) was significantly associated with poor 3-month outcomes in patients treated with MT. Subgroup analysis was conducted by comparing the successful recanalization group with the non-recanalization group, showing that BT ≥ 37.5 °C was associated with a significantly lower proportion of functional independence in the recanalized patients. Besides, the Kaplan-Meier model showed that the fever group had significantly lower survival rates than the non-fever group during the 3-month follow-up.
In patients treated with MT, hyperpyrexia is an independent predictor of poststroke outcomes at 3 months, particularly in those with successful recanalization.
关于机械取栓（MT）治疗患者的预后与体温（BT）之间关系的评估数据有限，尤其是在那些实现再通的患者中。我们旨在探讨BT在预测卒中后3个月恢复结局方面的预后价值。
我们回顾性分析了作为连续变量的BT水平、以发热（BT≥37.5℃）作为二元变量与多个感兴趣结局之间的关系。根据MT后成功再通（脑梗死溶栓评分2b - 3）对受试者进行分层。功能独立性定义为改良Rankin量表（mRS）评分为0 - 2。
总共纳入了258例患者。BT≥37.5℃的患者中功能独立的比例显著低于BT＜37.5℃的患者（45.3%对23.0%；P＜0.001）。在多变量分析中，高热（尤其是BT≥38℃）与接受MT治疗的患者3个月时不良结局显著相关。通过比较成功再通组与未再通组进行亚组分析，结果显示BT≥37.5℃与再通患者中功能独立比例显著降低相关。此外，Kaplan - Meier模型显示，在3个月随访期间，发热组的生存率显著低于非发热组。
在接受MT治疗的患者中，高热是卒中后3个月结局的独立预测因素，尤其是在那些成功再通的患者中。
