Treatment of Fever After Stroke: Conflicting Evidence

Approximately 50% of patients hospitalized for stroke develop fever. In fact, experimental evidence suggests that high body temperature is significantly correlated to initial stroke severity, lesion size, mortality, and neurologic outcome. Fever occurring after stroke is associated with poor outcome...

Full description

Saved in:
Bibliographic Details
Published in:Pharmacotherapy 2011-11, Vol.31 (11), p.1085-1091
Main Authors: Wrotek, Sylwia E., Kozak, Wieslaw E., Hess, David C., Fagan, Susan C.
Format: Article
Language:English
Subjects:
Acetaminophen - administration & dosage
Acetaminophen - adverse effects
Acetaminophen - therapeutic use
Animals
Antipyretics - administration & dosage
Antipyretics - adverse effects
Antipyretics - therapeutic use
Biological and medical sciences
Body Temperature
fever
Fever - epidemiology
Fever - etiology
Fever - therapy
Humans
hyperthermia
Hypothermia
inflammation
Medical sciences
Mortality
Neurology
Pharmacology. Drug treatments
Severity of Illness Index
Stroke
Stroke - complications
Stroke - mortality
Stroke - physiopathology
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Approximately 50% of patients hospitalized for stroke develop fever. In fact, experimental evidence suggests that high body temperature is significantly correlated to initial stroke severity, lesion size, mortality, and neurologic outcome. Fever occurring after stroke is associated with poor outcomes. We investigated the etiology of fever after stroke and present evidence evaluating the efficacy and safety of interventions used to treat stroke‐associated fever. Oral antipyretics are only marginally effective in lowering elevated body temperature in this population and may have unintended adverse consequences. Nonpharmacologic approaches to cooling have been more effective in achieving normothermia, but whether stroke outcomes can be improved remains unclear. We recommend using body temperature as a biomarker and a catalyst for aggressive investigation for an infectious etiology. Care must be taken not to exceed the new standard of a maximum acetaminophen dose of 3 g/day to avoid patient harm.
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.31.11.1085