自发性脑出血患者的连续体温监测：对温度模式和变异性的见解

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-06-08 DOI:10.1016/j.jstrokecerebrovasdis.2025.108366

Kornelia Laichinger MD , Annerose Mengel MD , Maria-Ioanna Stefanou MD , Sophia Kindzierski MD , Constanze Single MD , Lena S. Geiger MD , Till-Karsten Hauser MD , Ulf Ziemann MD , Markus Krumbholz MD , Katharina Feil MD

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引用次数: 0

摘要

自发性脑出血（ICH）经常与自主神经系统功能障碍相关，可能导致体温失调。方法回顾性分析261例脑出血患者入院后96小时连续监测的体温和变异性指标标准差（SD）、变异系数（CV）和连续变异性（SV）。功能指标包括出院时的改良Rankin量表（mRS）和90天随访。结果69例（26.4%）患者出现体温升高，与入院时美国国立卫生研究院卒中量表（NIHSS）评分增高（p = 0.003）、早期血肿扩大（p = 0.012）、ICU住院时间延长(p <；0.001)，出院时（p = 0.039）和随访时（p = 0.045）功能预后较差。体温升高的患者表现出更大的SD变异性，而SV保持相似。脑室内出血（p = 0.033）或较大出血（p = 0.019）的亚组易出现体温升高和SD变异性升高。Logistic回归显示，入院时年龄较小、发病前mr较低和NIHSS较低是90天良好预后的显著预测因素(例如，OR 0.352, CI 0.226 ~ 0.548, p <；发病前mr为0.001)。脑室内出血显著降低了恢复的可能性（OR 0.289, CI 0.123-0.682, p = 0.005, 0-24 h）。升高的温度有恶化预后的趋势（OR 2.445, 95% CI 0.994-6.011, p = 0.051），升高的温度变异性（SD）与前24小时的不良预后独立相关（OR 0.090, CI 0.009-0.956, p = 0.046）。结论脑出血患者24小时内体温升高和早期体温变化与较差的功能预后相关，强调了有针对性的体温调节策略的重要性。

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Continuous temperature monitoring in patients with spontaneous intracerebral hemorrhage: insights into temperature patterns and variability

Background

Spontaneous intracerebral hemorrhage (ICH) is frequently associated with autonomic nervous system dysfunction, potentially leading to temperature dysregulations.

Methods

This retrospective study analysis temperature and variability indices standard deviation (SD), coefficient of variation (CV) and successive variability (SV) continuously monitored over the first 96 hours post-admission in 261 ICH patients. Functional outcomes included the modified Rankin Scale (mRS) at discharge and 90-day follow-up.

Results

Elevated temperature occurred in 69 patients (26.4 %) and was associated with higher admission National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.003), early hematoma expansion (p = 0.012), longer ICU stays (p < 0.001), and worse functional outcomes at discharge (p = 0.039) and follow-up (p = 0.045). Patients with elevated temperature exhibited greater SD variability, while SV remained similar. Subgroups with intraventricular (p = 0.033), or larger hemorrhages (p = 0.019) were predisposed to elevated temperature and higher SD variability. Logistic regression revealed that younger age, lower premorbid mRS, and lower NIHSS at admission were significant predictors of good 90-day outcomes (e.g., OR 0.352, CI 0.226–0.548, p < 0.001 for premorbid mRS). Intraventricular hemorrhage significantly reduced the likelihood of recovery (OR 0.289, CI 0.123–0.682, p = 0.005 for 0–24 h). Elevated temperature showed a trend toward worse outcomes (OR 2.445, 95 %CI 0.994–6.011, p = 0.051), and increased temperature variability (SD) was independently associated with poor outcomes in the first 24 hours (OR 0.090, CI 0.009–0.956, p = 0.046).

Conclusions

Elevated temperature and early temperature variability within the first 24 hours are associated with worse functional outcomes in ICH patients, highlighting the importance of targeted thermoregulation strategies.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.