Kameshwar Prasad1, P R Krishnan. 1. Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India. drkameshwarprasad@yahoo.co.in
Abstract
OBJECTIVE: Association between fever and ischemic stroke mortality is known, but the magnitude and independence of the association is controversial. This paper aims to determine the size of independent effect of fever on short term mortality in acute ischemic stroke. METHODS: We searched the Medline and Cochrane library databases for papers studying the relationship between fever in acute ischemic stroke and short term mortality from January, 1990 to November, 2008. Two authors independently selected the studies for inclusion in the review using explicit criteria. Data was entered into software Revman 4.2.8. Heterogeneity was assessed using I² and chi-square statistics. Odds ratios (OR) from logistic regression were combined. Magnitude of association was determined using meta-analysis of the adjusted odds ratio using fixed effects model. RESULTS: Six cohort studies involving 2986 patients were included. There was no significant heterogeneity among studies reporting short-term mortality (I² = 21.2%, P = 0.28). Meta-analysis yielded a combined OR of 2.20 (95% CI 1.59-3.03, P < 0.00001). CONCLUSIONS: This meta-analysis suggests that fever within first 24 h of hospitalization in patients with ischemic stroke is associated with doubling of odds of mortality within one month of the onset of stroke.
OBJECTIVE: Association between fever and ischemic stroke mortality is known, but the magnitude and independence of the association is controversial. This paper aims to determine the size of independent effect of fever on short term mortality in acute ischemic stroke. METHODS: We searched the Medline and Cochrane library databases for papers studying the relationship between fever in acute ischemic stroke and short term mortality from January, 1990 to November, 2008. Two authors independently selected the studies for inclusion in the review using explicit criteria. Data was entered into software Revman 4.2.8. Heterogeneity was assessed using I² and chi-square statistics. Odds ratios (OR) from logistic regression were combined. Magnitude of association was determined using meta-analysis of the adjusted odds ratio using fixed effects model. RESULTS: Six cohort studies involving 2986 patients were included. There was no significant heterogeneity among studies reporting short-term mortality (I² = 21.2%, P = 0.28). Meta-analysis yielded a combined OR of 2.20 (95% CI 1.59-3.03, P < 0.00001). CONCLUSIONS: This meta-analysis suggests that fever within first 24 h of hospitalization in patients with ischemic stroke is associated with doubling of odds of mortality within one month of the onset of stroke.