High temperature predicts good short-term outcome after thrombolysis
MedWire News: A high body temperature may indicate a favorable short-term prognosis in stroke patients treated with tissue plasminogen activator (tPA), say researchers.
On the other hand, a low body temperature predicts good outcomes in patients who do not undergo thrombolysis, Halvor Naess (University of Bergen, Norway) and team report in Acta Neurologica Scandinavica.
“Thus, our study suggests that among patients receiving tPA, favorable prognosis is more dependent on the beneficial effect of high body temperature on clot lysis than on the neuroprotective effect of low body temperature, at least in the early phase of the stroke,” they say.
The prospective study included 111 patients who underwent thrombolysis and 139 who did not receive tPA and who presented within 6 hours of symptom onset.
Median body temperature was slightly lower among patients who received tPA, at 36.2oC compared with 36.6oC among those who did not. Patients who received tPA also had a higher median National Institutes of Health Stroke Scale (NIHSS) score than untreated patients, at 10 versus 3, and were more likely to have cardioembolic stroke.
Among patients who received tPA, each 1oC increase in body temperature was associated with a 3.7-fold increase in the likelihood of a favorable 1-week outcome, defined as a modified Rankin Scale score of 0–2. This relationship was independent of age, gender, and admission NIHSS score.
Conversely, among patients not given tPA, each 1oC decrease in body temperature improved the odds of a good outcome two fold.
“Our results may have important therapeutic implications,” say Naess et al.
“It is customary to treat elevated body temperature with pharmacologic or physical strategies in the acute stage even though there are no randomized trials favoring such strategies.”
They say that their findings in patients not receiving tPA support such strategies, but stress that they also “suggest caution as to lowering body temperature in stroke patients receiving tPA in the early phase.”
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By Eleanor McDermid