02400nas a2200277   4500000000100000008004100001260001700042100001500059700001500074700001700089700001600106700001300122700001500135700001300150700001400163700001400177700001400191700001200205700001300217245013700230250001500367300001100382490000700393520167100400020005102071       2015                            d  c-455721824511 aBeasley R.1 aPilcher D.1 aFinfer Simon1 aHarrison D.1 aRowan K.1 aBellomo R.1 aYoung P.1 aSaxena M.1 aMyburgh J1 aBailey M.1 aHyam J.1 aMenon D.00aEarly temperature and mortality in critically ill patients with acute neurological diseases: trauma and stroke differ from infection  a2015/02/04  a823-320 v413 a<p>
BACKGROUND: Fever suppression may be beneficial for patients with traumatic brain injury (TBI) and stroke, but for patients with meningitis or encephalitis [central nervous system (CNS) infection], the febrile response may be advantageous. OBJECTIVE: To evaluate the relationship between peak temperature in the first 24 h of intensive care unit (ICU) admission and all-cause hospital mortality for acute neurological diseases. DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort design from 2005 to 2013, including 934,159 admissions to 148 ICUs in Australia and New Zealand (ANZ) and 908,775 admissions to 236 ICUs in the UK. RESULTS: There were 53,942 (5.8 %) patients in ANZ and 56,696 (6.2 %) patients in the UK with a diagnosis of TBI, stroke or CNS infection. For both the ANZ (P = 0.02) and UK (P &lt; 0.0001) cohorts there was a significant interaction between early peak temperature and CNS infection, indicating that the nature of the relationship between in-hospital mortality and peak temperature differed between TBI/stroke and CNS infection. For patients with CNS infection, elevated peak temperature was not associated with an increased risk of death, relative to the risk at 37-37.4 degrees C (normothermia). For patients with stroke and TBI, peak temperature below 37 degrees C and above 39 degrees C was associated with an increased risk of death, compared to normothermia. CONCLUSIONS: The relationship between peak temperature in the first 24 h after ICU admission and in-hospital mortality differs for TBI/stroke compared to CNS infection. For CNS infection, increased temperature is not associated with increased risk of death.
</p>
  a1432-1238 (Electronic)<br/>0342-4642 (Linking)