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01-05-2004 | Original

Severe traumatic head injury in adults: Which patients are at risk of early hyperthermia?

Authors: Arnaud Geffroy, Régis Bronchard, Paul Merckx, Pierre-François Seince, Thierry Faillot, Pierre Albaladejo, Jean Marty

Published in: Intensive Care Medicine | Issue 5/2004

Abstract

Objective

Prevention of secondary insults, such as hyperthermia, is a major goal after traumatic brain injury. The aim of our study was to identify risk factors for early hyperthermia in severe head-injured patients.

Design

Retrospective cohort study.

Setting

A 17-bed multidisciplinary ICU of a 700-bed teaching hospital.

Patients

A total of 101 adult patients admitted from January 1999 to December 2001 requiring continuous monitoring of intracranial pressure according to international guidelines.

Measurement and results

Forty-four patients experienced early hyperthermia (at least one episode of body temperature >38.5°C within the first 2 days). On univariate analysis five variables were associated with early hyperthermia: sex; body temperature; white blood cell count on admission; prophylactic use of acetaminophen; and diabetes insipidus within 2 days. On multivariate analysis, white blood cell count >14.5×10⁹/l on admission (odds ratio, 7.1; 95% confidence interval, 2.4–20.5; p=0.001) and a body temperature on admission >36°C (odds ratio, 6.7; 95% confidence interval, 2.3-20.1) were strong risk factors of early hyperthermia. Prophylactic use of acetaminophen was negatively associated with early hyperthermia (odds ratio, 0.1; 95% confidence interval, 0.02–0.4). Patients who experienced early hyperthermia were less prone to have good recovery (GOS=5; p=0.03). More patients with severe or moderate disability (GOS=3 or 4) experienced early hyperthermia (p=0.01).

Conclusion

We identified a subgroup of patients at high risk of early hyperthermia, which is common in severe head-injured patients. These results could have clinical implications for prevention of hyperthermia after traumatic brain injury in adults.

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Title: Severe traumatic head injury in adults: Which patients are at risk of early hyperthermia?
Authors: Arnaud Geffroy
Régis Bronchard
Paul Merckx
Pierre-François Seince
Thierry Faillot
Pierre Albaladejo
Jean Marty
Publication date: 01-05-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2280-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe traumatic head injury in adults: Which patients are at risk of early hyperthermia?

Abstract

Objective

Design

Setting

Patients

Measurement and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Measurement and results

Conclusion

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