Abeer Feasal, Abdou El Azab, Karim Mashhour, Amr El Hadidy
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Temperature was measured from admission until the patients were discharged or died, and PCT was measured on day 1 of admission and after 48<!--> <!-->h of admission.</p></div><div><h3>Results</h3><p>Fever has been associated with poor outcome, as fever is linked to worse GCS scores (12.6<!--> <!-->±<!--> <!-->1.2 vs. 7.7<!--> <!-->±<!--> <!-->2.6 in patients with fever, <em>P</em> 0.001), longer MV durations (3.6<!--> <!-->±<!--> <!-->1.0 vs. 22.4<!--> <!-->±<!--> <!-->9.1<!--> <!-->days, in patients with fever, <em>P</em> 0.001), longer ICU length of stay (8.1<!--> <!-->±<!--> <!-->4.7 vs. 23.0<!--> <!-->±<!--> <!-->8.0<!--> <!-->days in patients with fever, <em>P</em> 0.001) and increased mortality (<em>P</em> <!-->=<!--> <!-->0.001). There were significantly higher PCT levels in the mortality group versus the survived group at day 1 (4.15<!--> <!-->±<!--> <!-->0.82 vs. 2.47<!--> <!-->±<!--> <!-->0.059<!--> <!-->ng/ml, respectively, <em>P</em> 0.0001) and after 48<!--> <!-->h of admission (5.20<!--> <!-->±<!--> <!-->1.14 vs. 3.19<!--> <!-->±<!--> <!-->0.092<!--> <!-->ng/ml, respectively, <em>P</em> 0.0001).</p></div><div><h3>Conclusion</h3><p>Fever had a strong link to worse GCS, longer MV durations, increased length of ICU stay, higher mortality rates and worse overall outcomes in neurocritical patients. High PCT levels can predict mortality in those patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2015.05.001","citationCount":"3","resultStr":"{\"title\":\"Impact of body temperature and serum procalcitonin on the outcomes of critically ill neurological patients\",\"authors\":\"Abeer Feasal, Abdou El Azab, Karim Mashhour, Amr El Hadidy\",\"doi\":\"10.1016/j.ejccm.2015.05.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Fever is common in patients with acute stroke, and mostly it is due to infectious complications. The neurologic effects of fever are significant, increased temperature in the post-injury period has been associated with increased cytokine activity and increased infarct size.</p></div><div><h3>Aim</h3><p>To test the hypothesis that fever and increased serum procalcitonin are associated with poor outcomes after neurological injury.</p></div><div><h3>Methodology</h3><p>Fifty patients (30 males (60%) and 20 females (40%) mean 43.8<!--> <!-->±<!--> <!-->11.7<!--> <!-->years) were divided into two groups: Group I: 25 traumatic patients (i.e., head injury) and Group II: 25 non-traumatic patients (i.e., stroke). Temperature was measured from admission until the patients were discharged or died, and PCT was measured on day 1 of admission and after 48<!--> <!-->h of admission.</p></div><div><h3>Results</h3><p>Fever has been associated with poor outcome, as fever is linked to worse GCS scores (12.6<!--> <!-->±<!--> <!-->1.2 vs. 7.7<!--> <!-->±<!--> <!-->2.6 in patients with fever, <em>P</em> 0.001), longer MV durations (3.6<!--> <!-->±<!--> <!-->1.0 vs. 22.4<!--> <!-->±<!--> <!-->9.1<!--> <!-->days, in patients with fever, <em>P</em> 0.001), longer ICU length of stay (8.1<!--> <!-->±<!--> <!-->4.7 vs. 23.0<!--> <!-->±<!--> <!-->8.0<!--> <!-->days in patients with fever, <em>P</em> 0.001) and increased mortality (<em>P</em> <!-->=<!--> <!-->0.001). There were significantly higher PCT levels in the mortality group versus the survived group at day 1 (4.15<!--> <!-->±<!--> <!-->0.82 vs. 2.47<!--> <!-->±<!--> <!-->0.059<!--> <!-->ng/ml, respectively, <em>P</em> 0.0001) and after 48<!--> <!-->h of admission (5.20<!--> <!-->±<!--> <!-->1.14 vs. 3.19<!--> <!-->±<!--> <!-->0.092<!--> <!-->ng/ml, respectively, <em>P</em> 0.0001).</p></div><div><h3>Conclusion</h3><p>Fever had a strong link to worse GCS, longer MV durations, increased length of ICU stay, higher mortality rates and worse overall outcomes in neurocritical patients. 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引用次数: 3
摘要
急性脑卒中患者常见发热，发热多由感染性并发症引起。发热对神经系统的影响是显著的，损伤后时期温度升高与细胞因子活性增加和梗死面积增加有关。目的验证发热和血清降钙素原升高与神经损伤后不良预后相关的假设。方法50例患者(男性30例(60%)，女性20例(40%)，平均年龄(43.8±11.7)岁)分为两组:ⅰ组:创伤性(即头部损伤)患者25例;ⅱ组:非创伤性(即脑卒中)患者25例。从入院至患者出院或死亡期间测量体温，在入院第1天和入院48 h后测量PCT。结果发热与预后不良相关，发热与较差的GCS评分(发热患者为12.6±1.2比7.7±2.6,P < 0.001)、较长的MV持续时间(发热患者为3.6±1.0比22.4±9.1天，P < 0.001)、较长的ICU住院时间(发热患者为8.1±4.7比23.0±8.0天，P < 0.001)和较高的死亡率(P = 0.001)相关。死亡组第1天PCT水平显著高于存活组(分别为4.15±0.82∶2.47±0.059 ng/ml, P 0.0001)和入院48 h后PCT水平分别为5.20±1.14∶3.19±0.092 ng/ml, P 0.0001)。结论发热与神经危重症患者GCS加重、MV持续时间延长、ICU住院时间延长、死亡率升高和总体预后恶化密切相关。高PCT水平可以预测这些患者的死亡率。
Impact of body temperature and serum procalcitonin on the outcomes of critically ill neurological patients
Introduction
Fever is common in patients with acute stroke, and mostly it is due to infectious complications. The neurologic effects of fever are significant, increased temperature in the post-injury period has been associated with increased cytokine activity and increased infarct size.
Aim
To test the hypothesis that fever and increased serum procalcitonin are associated with poor outcomes after neurological injury.
Methodology
Fifty patients (30 males (60%) and 20 females (40%) mean 43.8 ± 11.7 years) were divided into two groups: Group I: 25 traumatic patients (i.e., head injury) and Group II: 25 non-traumatic patients (i.e., stroke). Temperature was measured from admission until the patients were discharged or died, and PCT was measured on day 1 of admission and after 48 h of admission.
Results
Fever has been associated with poor outcome, as fever is linked to worse GCS scores (12.6 ± 1.2 vs. 7.7 ± 2.6 in patients with fever, P 0.001), longer MV durations (3.6 ± 1.0 vs. 22.4 ± 9.1 days, in patients with fever, P 0.001), longer ICU length of stay (8.1 ± 4.7 vs. 23.0 ± 8.0 days in patients with fever, P 0.001) and increased mortality (P = 0.001). There were significantly higher PCT levels in the mortality group versus the survived group at day 1 (4.15 ± 0.82 vs. 2.47 ± 0.059 ng/ml, respectively, P 0.0001) and after 48 h of admission (5.20 ± 1.14 vs. 3.19 ± 0.092 ng/ml, respectively, P 0.0001).
Conclusion
Fever had a strong link to worse GCS, longer MV durations, increased length of ICU stay, higher mortality rates and worse overall outcomes in neurocritical patients. High PCT levels can predict mortality in those patients.
期刊介绍：
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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