Influence of fever and hospital-acquired infection on the incidence of delayed neurological deficit and poor outcome after aneurysmal subarachnoid hemorrhage

G. Logan Douds, Bi Tadzong, Akash D. Agarwal, Satish Krishnamurthy, Erik B. Lehman, Kevin M. Cockroft

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number479865
JournalNeurology Research International
Volume2012
DOIs
StatePublished - Nov 1 2012

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Subarachnoid Hemorrhage
Cross Infection
Fever
Incidence
Infection
Causality
Logistic Models
Databases

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

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abstract = "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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Influence of fever and hospital-acquired infection on the incidence of delayed neurological deficit and poor outcome after aneurysmal subarachnoid hemorrhage. / Douds, G. Logan; Tadzong, Bi; Agarwal, Akash D.; Krishnamurthy, Satish; Lehman, Erik B.; Cockroft, Kevin M.

In: Neurology Research International, Vol. 2012, 479865, 01.11.2012.

Research output: Contribution to journalArticle

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