Body temperature and outcome after stroke thrombolysis

Aims - We studied whether baseline body temperature and temperature increases after stroke adversely affect outcome after thrombolysis with intravenous tissue plasminogen activator (IV tPA). Methods - The evolution of body temperature in the first 24 h after treatment with IV tPA was described by calculating the area under the curve of the temperature over time plot relative to temperature at admission (AUC(BL)) and relative to a standard value of 37 degrees C (AUC(37)). Temperature parameters were related to functional outcome. Results - The median baseline National Institutes of Health Stroke Scale of 100 consecutive patients was 16 (interquartile range 11-21) and 34 patients had a favourable response to tPA. Patients with an unfavourable outcome had a more important temperature elevation than patients who had a favourable outcome after tPA (+1 degrees C vs +0.6 degrees C, P = 0.02), despite similar baseline T and had a higher AUC(BL) (9.79 vs 5.36, P = 0.027) and more frequently showed hyperthermia relative to baseline (82% vs 56%, P = 0.011). After adjustment for baseline characteristics, the presence of hyperthermia relative to baseline was associated with a reduced odds of good outcome after thrombolysis (OR 0.34, 95% CI 0.10-0.95, P = 0.040). Conclusion - Hyperthermia relative to baseline temperature in the 24 h after intravenous thrombolysis is associated with an unfavourable outcome.