• Fuling Yan, Daopei Zhang, Haiqing Xu, and Haijian Guo.
• Department of Neurology, Zhongda Hospital, Southeast University, Nanjing 210009, China. yanfuling218@163.com
• Neurol. Res. 2008 May 1;30(4):394-9.

ObjectiveThe purpose of this project was to identify risk factors for fever among critically ill patients with acute new-onset stroke, treated in a neurological intensive care unit (NICU). The frequency and risk factors for fever in the stroke patients during the first 7 days after admission were retrospectively studied.MethodsFever was defined as a patient's axillary temperature >37.5 degrees C in two separate measurements or >37.8 degrees C in one single measurement. Multivariable logistic regressions were applied to analyse the risk factors for any fever, explained infectious fever and unexplained fever. One hundred and thirty-seven patients were included in the final analysis.ResultsFebrile episodes occurred in 65% (89/137) of the patients; 48.9% of the fever were explained by infection (predominantly pneumonia or bronchitis), and 15.3% were unexplained despite a complete diagnostic evaluation. Significant risk factors for any fever included age 65 years or older, impaired consciousness, extremity paralysis (muscle force < or = grade 3), center venous catheterization and tracheal intubation. In addition to those risk factors, the length of the stay at NICU before the fever was also a significant risk factor for explained infectious fever. Brain midline shift and initial serum leucocyte count more than 12.0 x 10(9)/l were significant risk factors for unexplained fever.ConclusionThese results suggest that critically ill and new-onset stroke patients treated in NICU often have fever. The risk factors for different types of fever vary considerably.

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