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The following is a summary of “Impact of fever on the outcome non-anoxic acute brain injury patients: a systematic review and meta-analysis,” published in the November 2024 issue of Critical Care by Bogossian et al.
Fever is more prevalent in patients admitted to intensive care unit (ICU), affecting 30-50% individuals of non-neurological and up to 70-90% of neurological ones.
Researchers conducted a retrospective study to perform the meta-analysis of existing literature on the impact of fever on neurological outcomes and mortality in patients with acute brain injury.
They searched PubMed/Medline, Scopus, and Embase databases adhering to PRISMA guidelines with retrospective, prospective observational, interventional, and randomized clinical trials with data on ICU temperature and fever. The Primary outcomes were neurological outcomes and mortality while, the secondary outcomes were early neurological deterioration, delayed cerebral ischemia (DCI) (for patients with subarachnoid hemorrhage), large infarct/hemorrhage size, and hemorrhagic transformation (for patients with ischemic stroke). The study was registered in PROSPERO (CRD42020155903).
The results showed that among 180 studies (4,60,825 patients), fever was associated with increased odds of unfavorable neurological outcome (pooled OR 2.37 [95% CI 2.08-2.71], I2 :92%), death (pooled OR 1.31 [95% CI 1.28-1.34], I2:93%), neurological deterioration (pooled OR 1.10 [95% CI 1.05-1.15]), DCI risk (pooled OR 1.96 [95% CI 1.73-2.22]), large infarct size (pooled OR 2.94 [95% CI 2.90-2.98]), hemorrhagic transformation (pooled OR 1.63 [95% CI 1.34-1.97]), and large hemorrhagic volume (pooled OR 2.38 [95% CI 1.94-2.93]).
They concluded the fever was associated with adverse neurological outcomes and high mortality rate in patients with acute brain injury, suggesting the potential benefit of targeted normothermia in neurocritical care.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05132-6
