Evidence map›Paper›PMID 39407147›Full record

ArticleBMC neurology2024

Postoperative fever and clinical outcomes after endoscopic surgery for spontaneous intracerebral hemorrhage: a retrospective database study.

Shuang Liu, Yunjian Zhang, Shengyang Su, Jirao Ren, Jinyong Long, Shikui Cao, Fuhua Li, Zihui Gao, Deqiang Wang, Xiaobiao Zhang

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shuang Liu *Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Yunjian Zhang *Department of Neurology, National Children's Medical Center, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Shanghai, 201102, China.
Shengyang Su *Department of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Jirao RenDepartment of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Jinyong LongDepartment of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Shikui CaoDepartment of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Fuhua LiDepartment of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Zihui GaoDepartment of Surgery, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Deqiang WangDepartment of Critical Care Medicine, People's Hospital of Jinping Miao, Yao and Dai Autonomous Country, No. 22, Guangjie Road, Honghe Prefecture, Yunnan Province, 661599, China.
Xiaobiao ZhangDepartment of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. xiaobiao_zhang@163.com.ORCID http://orcid.org/0000-0003-3970-1106

Funding

Clinical Research Project of People's Hospital of Jinping Miao, Yao, and Dai Autonomous County 2023-LC-05Science and Technology Innovation Action Plan" for Domestic S&T Cooperation 23015830700
6 · The paper itself

Abstract

backgroundSpontaneous intracerebral hemorrhage (SICH) is a severe stroke with high mortality and disability rates. Endoscopic surgery is an increasingly widely used minimally invasive method for the treatment of SICH. However, the impact of fever on patient outcomes remains unclear.

methodsWe retrospectively included patients aged 18 years or older with supratentorial SICH confirmed by CT, who underwent endoscopic hematoma evacuation within 48 h of symptom onset. The primary outcome was the modified Rankin Scale (mRS) score at 3 months. Secondary outcomes included hospital and neurosurgical intensive care unit (NSICU) stays, and perioperative complications. We analyzed the association between postoperative fever (highest temperature within 24 h after surgery) and these outcomes using multivariate analysis, generalized additive models, and segmented regression analysis.

resultsOf the 56 patients, 38 had favorable outcomes (mRS ≤ 3) and 18 had unfavorable outcomes (mRS > 3) at 3 months. A threshold effect at 38.2 °C was observed between postoperative body temperature and clinical outcomes. The mean age was 56 years (SD = 9) for the > 38.2 °C group and 58 years (SD = 8) for the ≤ 38.2 °C group, with a similar proportion of male patients (63% vs. 69%, P = 0.635). Patients with postoperative fever had larger hematoma volumes (65 vs. 56 mL; P = 0.008). Other characteristics were similar between the groups. Postoperative fever (> 38.2 °C) was independently associated with a 4.99-fold increased risk of unfavorable outcomes (95% CI = [1.13 to 25.90]; P = 0.040), which remained significant after excluding patients with postoperative complications (adjusted RR = 16.03, 95% CI = [1.69 to 417.24]; P = 0.033). The association was consistent across subgroups with different Glasgow Coma Scale scores, hematoma volumes, and intraventricular extension. Postoperative fever was also associated with longer NSICU stays (3.1 vs. 2.3 days; P = 0.023), longer hospital stays (17.2 vs. 13.6 days; P = 0.010), more residual hematoma, and greater edema volume. Different antipyretic therapies did not affect outcomes.

conclusionsThis study identifies a temperature threshold (38.2 °C) associated with poor outcomes in SICH patients undergoing endoscopic surgery. Further research is needed to mitigate postoperative fever and improve patient outcomes.

Indexed as

Cerebral HemorrhageFeverPostoperative ComplicationsAdultAgedDatabases, FactualFemaleHumansMaleMiddle AgedNeuroendoscopyRetrospective StudiesTreatment OutcomeAntipyretic therapyClinical outcomesEndoscopic surgeryPostoperative feverSpontaneous intracerebral hemorrhage

Identifiers

PMID39407147
PMCPMC11476804

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.