Periprocedural body temperature predicts EVT outcomes for large vessel occlusion stroke

A high body temperature is associated with poorer clinical outcomes in patients with large vessel occlusion stroke undergoing treatment with endovascular thrombectomy (EVT), as reported in a recent study.

The study involved 432 consecutive EVT patients (mean age, 65.6 years; 59 percent male). Temperature measurements within 24 hours of admission, categorized as pre-EVT (preprocedural and intraprocedural) and post-EVT, served as surrogates for the intraischaemic and postischaemic phases of large vessel occlusion stroke, respectively.

Median temperature pre-EVT (admission until EVT completion) was 36.2 °C, while that of post-EVT (postanesthesia care unit until 24 hours following admission) was 36.4 °C. Acetaminophen was given to 215 patients (49.8 percent) during the first 24 hours of admission. At least one temperature measurement of ≥38 °C was recorded for seven patients (1.6 percent) pre-EVT and 16 (3.7 percent) post-EVT.

In multivariable logistic regression models, higher pre-EVT temperature (per 1 °C increase) independently predicted poor outcomes at month 3: reduced functional independence (modified Rankin Scale [mRS] score of >2; odds ratio [OR], 0.66, 95 percent confidence interval [CI], 0.46–0.94; p=0.02), poorer mRS scores (common OR, 1.42, 95 percent CI, 1.08–1.85; p=0.01) and increased mortality (OR, 1.65, 95 percent CI, 1.02–2.69; p=0.04).

Peak post-EVT temperature (per 1 °C increase) also predicted higher mRS scores (common OR, 1.39, 95 percent CI, 1.03–1.90; p=0.03) and higher mortality (OR, 1.66, 95 percent CI, 1.04–2.67; p=0.03).

Additional studies are needed to ascertain the role of maintaining normothermia or therapeutic hypothermia in patients needing to be transferred from primary to EVT-capable stroke centres, researchers said.