Influence of Fever and Hospital-Acquired Infection on the Incidence of Delayed Neurological Deficit and Poor Outcome after Aneurysmal Subarachnoid Hemorrhage

被引:24
作者
Douds, G. Logan [1 ]
Tadzong, Bi [2 ]
Agarwal, Akash D. [1 ]
Krishnamurthy, Satish [3 ]
Lehman, Erik B. [4 ]
Cockroft, Kevin M. [1 ,4 ]
机构
[1] Penn State Milton S Hershey Med Ctr & Coll Med, Dept Neurosurg, Hershey, PA 17033 USA
[2] Penn State Univ, Coll Med, Hershey, PA 17033 USA
[3] SUNY Upstate Med Univ, Dept Neurosurg, Syracuse, NY 13210 USA
[4] Penn State Milton S Hershey Med Ctr, Dept Publ Hlth Sci, Hershey, PA 17033 USA
关键词
D O I
10.1155/2012/479865
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Although fever and infection have been implicated in the causation of delayed neurological deficits (DND) and poor outcome after aneurysmal subarachnoid hemorrhage (SAH), the relationship between these two often related events has not been extensively studied. We reviewed these events through of our retrospective database of patients with SAH. Multivariate logistic regression was used to determine independent predictors of DND and poor outcome. A total of 186 patients were analyzed. DND was noted in 76 patients (45%). Fever was recorded in 102 patients (55%); infection was noted in 87 patients (47%). A patient with one infection was more likely to experience DND compared to a patient with no infections (adjusted OR 3.73, 95% CI 1.62, 8.59). For those with more than two infections the likelihood of DND was even greater (adjusted OR 4.24, 95% CI 1.55, 11.56). Patients with 1-2 days of fever were less likely to have a favorable outcome when compared to their counterparts with no fever (adjusted OR 0.19, 95% CI 0.06, 0.62). This trend worsened as the number of days febrile increased. These data suggest that the presence of infection is associated with DND, but that fever may have a stronger independent association with overall outcome.
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