La febbre si associa ad una maggiore mortalitá a breve termine in pazienti anziani con ictus ischemico

Objective: in animal models with cerebral ischemia, an increase in body temperature is associated with a larger infarction size. In patients with acute ischemic stroke body temperature within normal values is associated with lower mortality and few neurological defects. The aim of our study is to verify whether an increase in body temperature is an independent predictor of short term mortality. Methods: data concerning 359 old patients consecutively admitted to Internal Medicine ad Geriatrics university Department for “major” acute ischemic stroke have been collected with regard to clinical history, clinical and neurological examination, and laboratory parameters. Fever has been defined as a body temperature higher than 37° Celsius occurred within the first week after admission to the hospital. Short term mortality (within 30 days) was the main outcome of the study. Results: the overall short-term mortality was 28.3%. Among subjects with fever (136, 37.9%) occurred 52.9% of deceased. Fever was associated with mortality at the univariate logistic analysis (OR = 4.8 IC 95%: 3.1-7.8; p = 0.001). After multivariate adjustment for potential confounders the risk of death was still double in subjects with high body temperature (OR = 2.1 IC 95%: 1.1-4.3; p = 0.002). Conclusions: our study confirm the role of fever as predictor of short-term mortality in old subjects with ischemic stroke. This association seems to be independent of many conditions possibly related with fever or death