Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage

Michael M. Todd, Bradley J. Hindman, William R. Clarke, James C. Torner, Julie B. Weeks, Emine O. Bayman, Qian Shi, Christina M. Spofford, K. Chaloner, P. Davis, M. Howard, D. Tranel, L. Moss, J. Winn, M. Wichman, R. Peters, M. Hansen, D. Anderson, J. Lang, B. Yoo & 490 others H. Adams, G. Clifton, A. Gelb, C. Loftus, D. Warner, W. Young, R. Frankowski, K. Kieburtz, D. Prough, L. Sternau, J. Marler, C. Moy, B. Radziszewska, B. Matta, P. Kirkpatrick, D. Chatfield, C. Skilbeck, R. Kirollos, F. Rasulo, K. English, C. Duffy, K. Pedersen, N. Scurrah, R. Burnstein, A. Prabhu, C. Salmond, A. Blackwell, J. Birrell, S. Jackson, N. Kassell, T. Pajewski, H. Fraley, A. Morris, T. Alden, M. Shaffrey, D. Bogdonoff, M. Durieux, Z. Zuo, K. Littlewood, E. Nemergut, R. Bedford, D. Stone, P. Balestrieri, J. Mason, G. Henry, P. Ting, J. Shafer, T. Blount, L. Kim, A. James, E. Farace, L. Clark, M. Irons, T. Sasaki, K. Webb, T. Short, E. Mee, J. Ormrod, J. Jane, T. Alden, P. Heppner, S. Olson, D. Ellegala, C. Lind, J. Sheehan, M. Woodfield, A. Law, M. Harrison, P. Davies, D. Campbell, N. Robertson, R. Fry, D. Sage, S. Laurent, C. Bradfield, K. Pedersen, K. Smith, Y. Young, C. Chambers, B. Hodkinson, J. Biddulph, L. Jensen, J. Ogden, Z. Thayer, F. Lee, S. Crump, J. Quaedackers, A. Wray, V. Roelfsema, R. Greif, G. Kleinpeter, C. Lothaller, E. Knosp, W. Pfisterer, R. Schatzer, C. Salem, W. Kutalek, E. Tuerkkan, L. Koller, T. Weber, A. Buchmann, C. Merhaut, M. Graf, B. Rapf, A. Lam, D. Newell, P. Tanzi, L. Lee, K. Domino, M. Vavilala, J. Bramhall, M. Souter, G. Britz, H. Winn, H. Bybee, T. Costello, M. Murphy, K. Harris, C. Thien, D. Nye, T. Han, P. McNeill, B. O'Brien, J. Cormack, A. Wyss, R. Grauer, R. Popovic, S. Jones, R. Deam, G. Heard, R. Watson, L. Evered, F. Bardenhagen, C. Meade, J. Haartsen, J. Kruger, M. Wilson, M. Maktabi, V. Traynelis, A. McAllister, P. Leonard, B. Hindman, J. Brian, F. Mensink, R. From, D. Papworth, P. Schmid, D. Dehring, P. Hitchon, J. VanGilder, J. Weeks, K. Manzel, S. Anderson, R. Tack, D. Taggard, P. Lennarson, M. Menhusen, S. Lownie, R. Craen, T. Novick, G. Ferguson, N. Duggal, J. Findlay, W. Ng, D. Cowie, N. Badner, I. Herrick, H. Smith, G. Heard, R. Peterson, J. Howell, L. Lindsey, L. Carriere, M. von Lewinski, B. Schaefer, D. Bisnaire, P. Doyle-Pettypiece, M. McTaggart, S. Giannotta, V. Zelman, E. Thomson, E. Babayan, C. McCleary, D. Fishback, S. Samra, B. Thompson, W. Chandler, J. Mcgillicuddy, K. Tremper, C. Turner, P. Smythe, E. Dy, S. Pai, V. Portman, J. Palmisano, D. Auer, M. Quigley, B. Giordani, A. Freymuth, P. Scott, R. Silbergleit, S. Hickenbottom, L. Litt, M. Lawton, L. Hannegan, D. Gupta, P. Bickler, B. Dodson, P. Talke, I. Rampil, B. Chen, P. Wright, J. Mitchell, S. Ryan, J. Walker, N. Quinnine, C. Applebury, P. Myles, J. Rosenfeld, J. Hunt, S. Wallace, P. D'Urso, C. Thien, J. McMahon, S. Wadanamby, K. Siu, G. Malham, J. Laidlaw, S. Salerno, S. Alatakis, H. Madder, S. Cairo, A. Konstantatos, J. Smart, D. Lindholm, D. Bain, H. Machlin, J. Moloney, M. Buckland, A. Silvers, G. Downey, A. Molnar, M. Langley, D. McIlroy, D. Daly, P. Bennett, L. Forlano, R. Testa, W. Burnett, F. Johnson, M. Angliss, H. Fletcher, P. Manninen, M. Wallace, K. Lukitto, M. Tymianski, P. Porter, F. Gentili, H. El-Beheiry, M. Mosa, P. Mak, M. Balki, S. Shaikh, R. Sawyer, K. Quader, R. Chelliah, P. Berklayd, N. Merah, G. Ghazali, M. McAndrews, J. Ridgley, O. Odukoya, S. Yantha, J. Wilson, P. Petrozza, C. Miller, K. O'Brien, C. Tong, M. Olympio, J. Reynolds, D. Colonna, S. Glazier, S. Nobles, D. Hill, H. Hulbert, W. Jenkins, W. Lanier, D. Piepgras, R. Wilson, F. Meyer, J. Atkinson, M. Link, M. Weglinski, K. Berge, D. McGregor, M. Trenerry, G. Smith, J. Walkes, M. Felmlee-Devine, H. Van Aken, C. Greiner, H. Freise, H. Brors, K. Hahnenkamp, N. Monteirode Oliveira, C. Schul, D. Moskopp, J. Woelfer, C. Hoenemann, H. Gramke, H. Bone, I. Gibmeier, S. Wirtz, H. Lohmann, J. Freyhoff, B. Bauer, K. Hogan, R. Dempsey, D. Rusy, B. Badie, B. Iskandar, D. Resnick, P. Deshmukh, J. Fitzpatrick, F. Sasse, T. Broderick, K. Willmann, L. Connery, J. Kish, C. Weasler, N. Page, B. Hermann, J. Jones, D. Dulli, H. Stanko, M. Geraghty, R. Elbe, F. Saleversusky, R. Leblanc, N. Lapointe, H. Macgregor, D. Sinclair, D. Sirhan, M. Maleki, M. Abou-Madi, D. Chartrand, M. Angle, D. Milovan, Y. Painchaud, M. Mirski, R. Tamargo, S. Rice, A. Olivi, D. Kim, D. Rigamonti, N. Naff, M. Hemstreet, L. Berkow, P. Chery, J. Ulatowski, L. Moore, T. Cunningham, N. McBee, T. Hartman, J. Heidler, A. Hillis, E. Tuffiash, C. Chase, A. Kane, D. Greene-Chandos, M. Torbey, W. Ziai, K. Lane, A. Bhardwaj, N. Subhas, M. Mayberg, M. Beven, P. Rasmussen, H. Woo, S. Bhatia, Z. Ebrahim, M. Lotto, F. Vasarhelyi, J. Munis, K. Graves, J. Woletz, G. Chelune, S. Samples, J. Evans, D. Blair, A. Abou-Chebl, F. Shutway, D. Manke, C. Beven, P. Fogarty-Mack, P. Stieg, R. Eliazo, P. Li, H. Riina, C. Lien, L. Ravdin, J. Wang, Y. Kuo, R. Jaffe, G. Steinberg, D. Luu, S. Chang, R. Giffard, H. Lemmens, R. Morgan, A. Mathur, M. Angst, A. Meyer, H. Yi, P. Karzmark, T. Bell-Stephens, M. Marcellus, J. Sneyd, L. Pobereskin, S. Salsbury, P. Whitfield, R. Sawyer, A. Dashfield, R. Struthers, P. Davies, A. Rushton, V. Petty, S. Harding, E. Richardson, H. Yonas, F. Gyulai, L. Kirby, A. Kassam, N. Bircher, L. Meng, J. Krugh, G. Seever, R. Hendrickson, J. Gebel, D. Cowie, G. Fabinyi, S. Poustie, G. Davis, A. Drnda, D. Chandrasekara, J. Sturm, T. Phan, A. Shelton, M. Clausen, S. Micallef, A. Sills, F. Steinman, P. Sutton, J. Sanders, D. Van Alstine, D. Leggett, E. Cunningham, W. Hamm, B. Frankel, J. Sorenson, L. Atkins, A. Redmond, S. Dalrymple, S. Black, W. Fisher, C. Hall, D. Wilhite, T. Moore, P. Blanton, Z. Sha, P. Szmuk, D. Kim, A. Ashtari, C. Hagberg, M. Matuszczak, A. Shahen, O. Moise, D. Novy, R. Govindaraj, L. Jameson, R. Breeze, I. Awad, R. Mattison, T. Anderson, L. Salvia, M. Mosier, J. Smith, W. Lilley, B. White, M. Lenaerts

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

OBJECTIVE:We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36°C-37°C) or hypothermia (32.5°C-33.5°C). Fever (≥38.5°C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever- related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

Original languageEnglish (US)
Pages (from-to)897-908
Number of pages12
JournalNeurosurgery
Volume64
Issue number5
DOIs
StatePublished - May 2009

Fingerprint

Subarachnoid Hemorrhage
Fever
Outcome Assessment (Health Care)
Glasgow Outcome Scale
Hypothermia
Infection
Intraoperative Period
Surgical Blood Loss
Preoperative Period
Age Factors
National Institutes of Health (U.S.)
Intracranial Aneurysm
Hydrocephalus
Activities of Daily Living
Postoperative Period
Aneurysm
Logistic Models
Stroke

Keywords

  • Clinical trial
  • Fever
  • Infection
  • Postoperative care
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Todd, M. M., Hindman, B. J., Clarke, W. R., Torner, J. C., Weeks, J. B., Bayman, E. O., ... Lenaerts, M. (2009). Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage. Neurosurgery, 64(5), 897-908. https://doi.org/10.1227/01.NEU.0000341903.11527.2F

Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage. / Todd, Michael M.; Hindman, Bradley J.; Clarke, William R.; Torner, James C.; Weeks, Julie B.; Bayman, Emine O.; Shi, Qian; Spofford, Christina M.; Chaloner, K.; Davis, P.; Howard, M.; Tranel, D.; Moss, L.; Winn, J.; Wichman, M.; Peters, R.; Hansen, M.; Anderson, D.; Lang, J.; Yoo, B.; Adams, H.; Clifton, G.; Gelb, A.; Loftus, C.; Warner, D.; Young, W.; Frankowski, R.; Kieburtz, K.; Prough, D.; Sternau, L.; Marler, J.; Moy, C.; Radziszewska, B.; Matta, B.; Kirkpatrick, P.; Chatfield, D.; Skilbeck, C.; Kirollos, R.; Rasulo, F.; English, K.; Duffy, C.; Pedersen, K.; Scurrah, N.; Burnstein, R.; Prabhu, A.; Salmond, C.; Blackwell, A.; Birrell, J.; Jackson, S.; Kassell, N.; Pajewski, T.; Fraley, H.; Morris, A.; Alden, T.; Shaffrey, M.; Bogdonoff, D.; Durieux, M.; Zuo, Z.; Littlewood, K.; Nemergut, E.; Bedford, R.; Stone, D.; Balestrieri, P.; Mason, J.; Henry, G.; Ting, P.; Shafer, J.; Blount, T.; Kim, L.; James, A.; Farace, E.; Clark, L.; Irons, M.; Sasaki, T.; Webb, K.; Short, T.; Mee, E.; Ormrod, J.; Jane, J.; Alden, T.; Heppner, P.; Olson, S.; Ellegala, D.; Lind, C.; Sheehan, J.; Woodfield, M.; Law, A.; Harrison, M.; Davies, P.; Campbell, D.; Robertson, N.; Fry, R.; Sage, D.; Laurent, S.; Bradfield, C.; Pedersen, K.; Smith, K.; Young, Y.; Chambers, C.; Hodkinson, B.; Biddulph, J.; Jensen, L.; Ogden, J.; Thayer, Z.; Lee, F.; Crump, S.; Quaedackers, J.; Wray, A.; Roelfsema, V.; Greif, R.; Kleinpeter, G.; Lothaller, C.; Knosp, E.; Pfisterer, W.; Schatzer, R.; Salem, C.; Kutalek, W.; Tuerkkan, E.; Koller, L.; Weber, T.; Buchmann, A.; Merhaut, C.; Graf, M.; Rapf, B.; Lam, A.; Newell, D.; Tanzi, P.; Lee, L.; Domino, K.; Vavilala, M.; Bramhall, J.; Souter, M.; Britz, G.; Winn, H.; Bybee, H.; Costello, T.; Murphy, M.; Harris, K.; Thien, C.; Nye, D.; Han, T.; McNeill, P.; O'Brien, B.; Cormack, J.; Wyss, A.; Grauer, R.; Popovic, R.; Jones, S.; Deam, R.; Heard, G.; Watson, R.; Evered, L.; Bardenhagen, F.; Meade, C.; Haartsen, J.; Kruger, J.; Wilson, M.; Maktabi, M.; Traynelis, V.; McAllister, A.; Leonard, P.; Hindman, B.; Brian, J.; Mensink, F.; From, R.; Papworth, D.; Schmid, P.; Dehring, D.; Hitchon, P.; VanGilder, J.; Weeks, J.; Manzel, K.; Anderson, S.; Tack, R.; Taggard, D.; Lennarson, P.; Menhusen, M.; Lownie, S.; Craen, R.; Novick, T.; Ferguson, G.; Duggal, N.; Findlay, J.; Ng, W.; Cowie, D.; Badner, N.; Herrick, I.; Smith, H.; Heard, G.; Peterson, R.; Howell, J.; Lindsey, L.; Carriere, L.; von Lewinski, M.; Schaefer, B.; Bisnaire, D.; Doyle-Pettypiece, P.; McTaggart, M.; Giannotta, S.; Zelman, V.; Thomson, E.; Babayan, E.; McCleary, C.; Fishback, D.; Samra, S.; Thompson, B.; Chandler, W.; Mcgillicuddy, J.; Tremper, K.; Turner, C.; Smythe, P.; Dy, E.; Pai, S.; Portman, V.; Palmisano, J.; Auer, D.; Quigley, M.; Giordani, B.; Freymuth, A.; Scott, P.; Silbergleit, R.; Hickenbottom, S.; Litt, L.; Lawton, M.; Hannegan, L.; Gupta, D.; Bickler, P.; Dodson, B.; Talke, P.; Rampil, I.; Chen, B.; Wright, P.; Mitchell, J.; Ryan, S.; Walker, J.; Quinnine, N.; Applebury, C.; Myles, P.; Rosenfeld, J.; Hunt, J.; Wallace, S.; D'Urso, P.; Thien, C.; McMahon, J.; Wadanamby, S.; Siu, K.; Malham, G.; Laidlaw, J.; Salerno, S.; Alatakis, S.; Madder, H.; Cairo, S.; Konstantatos, A.; Smart, J.; Lindholm, D.; Bain, D.; Machlin, H.; Moloney, J.; Buckland, M.; Silvers, A.; Downey, G.; Molnar, A.; Langley, M.; McIlroy, D.; Daly, D.; Bennett, P.; Forlano, L.; Testa, R.; Burnett, W.; Johnson, F.; Angliss, M.; Fletcher, H.; Manninen, P.; Wallace, M.; Lukitto, K.; Tymianski, M.; Porter, P.; Gentili, F.; El-Beheiry, H.; Mosa, M.; Mak, P.; Balki, M.; Shaikh, S.; Sawyer, R.; Quader, K.; Chelliah, R.; Berklayd, P.; Merah, N.; Ghazali, G.; McAndrews, M.; Ridgley, J.; Odukoya, O.; Yantha, S.; Wilson, J.; Petrozza, P.; Miller, C.; O'Brien, K.; Tong, C.; Olympio, M.; Reynolds, J.; Colonna, D.; Glazier, S.; Nobles, S.; Hill, D.; Hulbert, H.; Jenkins, W.; Lanier, W.; Piepgras, D.; Wilson, R.; Meyer, F.; Atkinson, J.; Link, M.; Weglinski, M.; Berge, K.; McGregor, D.; Trenerry, M.; Smith, G.; Walkes, J.; Felmlee-Devine, M.; Van Aken, H.; Greiner, C.; Freise, H.; Brors, H.; Hahnenkamp, K.; Monteirode Oliveira, N.; Schul, C.; Moskopp, D.; Woelfer, J.; Hoenemann, C.; Gramke, H.; Bone, H.; Gibmeier, I.; Wirtz, S.; Lohmann, H.; Freyhoff, J.; Bauer, B.; Hogan, K.; Dempsey, R.; Rusy, D.; Badie, B.; Iskandar, B.; Resnick, D.; Deshmukh, P.; Fitzpatrick, J.; Sasse, F.; Broderick, T.; Willmann, K.; Connery, L.; Kish, J.; Weasler, C.; Page, N.; Hermann, B.; Jones, J.; Dulli, D.; Stanko, H.; Geraghty, M.; Elbe, R.; Saleversusky, F.; Leblanc, R.; Lapointe, N.; Macgregor, H.; Sinclair, D.; Sirhan, D.; Maleki, M.; Abou-Madi, M.; Chartrand, D.; Angle, M.; Milovan, D.; Painchaud, Y.; Mirski, M.; Tamargo, R.; Rice, S.; Olivi, A.; Kim, D.; Rigamonti, D.; Naff, N.; Hemstreet, M.; Berkow, L.; Chery, P.; Ulatowski, J.; Moore, L.; Cunningham, T.; McBee, N.; Hartman, T.; Heidler, J.; Hillis, A.; Tuffiash, E.; Chase, C.; Kane, A.; Greene-Chandos, D.; Torbey, M.; Ziai, W.; Lane, K.; Bhardwaj, A.; Subhas, N.; Mayberg, M.; Beven, M.; Rasmussen, P.; Woo, H.; Bhatia, S.; Ebrahim, Z.; Lotto, M.; Vasarhelyi, F.; Munis, J.; Graves, K.; Woletz, J.; Chelune, G.; Samples, S.; Evans, J.; Blair, D.; Abou-Chebl, A.; Shutway, F.; Manke, D.; Beven, C.; Fogarty-Mack, P.; Stieg, P.; Eliazo, R.; Li, P.; Riina, H.; Lien, C.; Ravdin, L.; Wang, J.; Kuo, Y.; Jaffe, R.; Steinberg, G.; Luu, D.; Chang, S.; Giffard, R.; Lemmens, H.; Morgan, R.; Mathur, A.; Angst, M.; Meyer, A.; Yi, H.; Karzmark, P.; Bell-Stephens, T.; Marcellus, M.; Sneyd, J.; Pobereskin, L.; Salsbury, S.; Whitfield, P.; Sawyer, R.; Dashfield, A.; Struthers, R.; Davies, P.; Rushton, A.; Petty, V.; Harding, S.; Richardson, E.; Yonas, H.; Gyulai, F.; Kirby, L.; Kassam, A.; Bircher, N.; Meng, L.; Krugh, J.; Seever, G.; Hendrickson, R.; Gebel, J.; Cowie, D.; Fabinyi, G.; Poustie, S.; Davis, G.; Drnda, A.; Chandrasekara, D.; Sturm, J.; Phan, T.; Shelton, A.; Clausen, M.; Micallef, S.; Sills, A.; Steinman, F.; Sutton, P.; Sanders, J.; Van Alstine, D.; Leggett, D.; Cunningham, E.; Hamm, W.; Frankel, B.; Sorenson, J.; Atkins, L.; Redmond, A.; Dalrymple, S.; Black, S.; Fisher, W.; Hall, C.; Wilhite, D.; Moore, T.; Blanton, P.; Sha, Z.; Szmuk, P.; Kim, D.; Ashtari, A.; Hagberg, C.; Matuszczak, M.; Shahen, A.; Moise, O.; Novy, D.; Govindaraj, R.; Jameson, L.; Breeze, R.; Awad, I.; Mattison, R.; Anderson, T.; Salvia, L.; Mosier, M.; Smith, J.; Lilley, W.; White, B.; Lenaerts, M.

In: Neurosurgery, Vol. 64, No. 5, 05.2009, p. 897-908.

Research output: Contribution to journalArticle

Todd, MM, Hindman, BJ, Clarke, WR, Torner, JC, Weeks, JB, Bayman, EO, Shi, Q, Spofford, CM, Chaloner, K, Davis, P, Howard, M, Tranel, D, Moss, L, Winn, J, Wichman, M, Peters, R, Hansen, M, Anderson, D, Lang, J, Yoo, B, Adams, H, Clifton, G, Gelb, A, Loftus, C, Warner, D, Young, W, Frankowski, R, Kieburtz, K, Prough, D, Sternau, L, Marler, J, Moy, C, Radziszewska, B, Matta, B, Kirkpatrick, P, Chatfield, D, Skilbeck, C, Kirollos, R, Rasulo, F, English, K, Duffy, C, Pedersen, K, Scurrah, N, Burnstein, R, Prabhu, A, Salmond, C, Blackwell, A, Birrell, J, Jackson, S, Kassell, N, Pajewski, T, Fraley, H, Morris, A, Alden, T, Shaffrey, M, Bogdonoff, D, Durieux, M, Zuo, Z, Littlewood, K, Nemergut, E, Bedford, R, Stone, D, Balestrieri, P, Mason, J, Henry, G, Ting, P, Shafer, J, Blount, T, Kim, L, James, A, Farace, E, Clark, L, Irons, M, Sasaki, T, Webb, K, Short, T, Mee, E, Ormrod, J, Jane, J, Alden, T, Heppner, P, Olson, S, Ellegala, D, Lind, C, Sheehan, J, Woodfield, M, Law, A, Harrison, M, Davies, P, Campbell, D, Robertson, N, Fry, R, Sage, D, Laurent, S, Bradfield, C, Pedersen, K, Smith, K, Young, Y, Chambers, C, Hodkinson, B, Biddulph, J, Jensen, L, Ogden, J, Thayer, Z, Lee, F, Crump, S, Quaedackers, J, Wray, A, Roelfsema, V, Greif, R, Kleinpeter, G, Lothaller, C, Knosp, E, Pfisterer, W, Schatzer, R, Salem, C, Kutalek, W, Tuerkkan, E, Koller, L, Weber, T, Buchmann, A, Merhaut, C, Graf, M, Rapf, B, Lam, A, Newell, D, Tanzi, P, Lee, L, Domino, K, Vavilala, M, Bramhall, J, Souter, M, Britz, G, Winn, H, Bybee, H, Costello, T, Murphy, M, Harris, K, Thien, C, Nye, D, Han, T, McNeill, P, O'Brien, B, Cormack, J, Wyss, A, Grauer, R, Popovic, R, Jones, S, Deam, R, Heard, G, Watson, R, Evered, L, Bardenhagen, F, Meade, C, Haartsen, J, Kruger, J, Wilson, M, Maktabi, M, Traynelis, V, McAllister, A, Leonard, P, Hindman, B, Brian, J, Mensink, F, From, R, Papworth, D, Schmid, P, Dehring, D, Hitchon, P, VanGilder, J, Weeks, J, Manzel, K, Anderson, S, Tack, R, Taggard, D, Lennarson, P, Menhusen, M, Lownie, S, Craen, R, Novick, T, Ferguson, G, Duggal, N, Findlay, J, Ng, W, Cowie, D, Badner, N, Herrick, I, Smith, H, Heard, G, Peterson, R, Howell, J, Lindsey, L, Carriere, L, von Lewinski, M, Schaefer, B, Bisnaire, D, Doyle-Pettypiece, P, McTaggart, M, Giannotta, S, Zelman, V, Thomson, E, Babayan, E, McCleary, C, Fishback, D, Samra, S, Thompson, B, Chandler, W, Mcgillicuddy, J, Tremper, K, Turner, C, Smythe, P, Dy, E, Pai, S, Portman, V, Palmisano, J, Auer, D, Quigley, M, Giordani, B, Freymuth, A, Scott, P, Silbergleit, R, Hickenbottom, S, Litt, L, Lawton, M, Hannegan, L, Gupta, D, Bickler, P, Dodson, B, Talke, P, Rampil, I, Chen, B, Wright, P, Mitchell, J, Ryan, S, Walker, J, Quinnine, N, Applebury, C, Myles, P, Rosenfeld, J, Hunt, J, Wallace, S, D'Urso, P, Thien, C, McMahon, J, Wadanamby, S, Siu, K, Malham, G, Laidlaw, J, Salerno, S, Alatakis, S, Madder, H, Cairo, S, Konstantatos, A, Smart, J, Lindholm, D, Bain, D, Machlin, H, Moloney, J, Buckland, M, Silvers, A, Downey, G, Molnar, A, Langley, M, McIlroy, D, Daly, D, Bennett, P, Forlano, L, Testa, R, Burnett, W, Johnson, F, Angliss, M, Fletcher, H, Manninen, P, Wallace, M, Lukitto, K, Tymianski, M, Porter, P, Gentili, F, El-Beheiry, H, Mosa, M, Mak, P, Balki, M, Shaikh, S, Sawyer, R, Quader, K, Chelliah, R, Berklayd, P, Merah, N, Ghazali, G, McAndrews, M, Ridgley, J, Odukoya, O, Yantha, S, Wilson, J, Petrozza, P, Miller, C, O'Brien, K, Tong, C, Olympio, M, Reynolds, J, Colonna, D, Glazier, S, Nobles, S, Hill, D, Hulbert, H, Jenkins, W, Lanier, W, Piepgras, D, Wilson, R, Meyer, F, Atkinson, J, Link, M, Weglinski, M, Berge, K, McGregor, D, Trenerry, M, Smith, G, Walkes, J, Felmlee-Devine, M, Van Aken, H, Greiner, C, Freise, H, Brors, H, Hahnenkamp, K, Monteirode Oliveira, N, Schul, C, Moskopp, D, Woelfer, J, Hoenemann, C, Gramke, H, Bone, H, Gibmeier, I, Wirtz, S, Lohmann, H, Freyhoff, J, Bauer, B, Hogan, K, Dempsey, R, Rusy, D, Badie, B, Iskandar, B, Resnick, D, Deshmukh, P, Fitzpatrick, J, Sasse, F, Broderick, T, Willmann, K, Connery, L, Kish, J, Weasler, C, Page, N, Hermann, B, Jones, J, Dulli, D, Stanko, H, Geraghty, M, Elbe, R, Saleversusky, F, Leblanc, R, Lapointe, N, Macgregor, H, Sinclair, D, Sirhan, D, Maleki, M, Abou-Madi, M, Chartrand, D, Angle, M, Milovan, D, Painchaud, Y, Mirski, M, Tamargo, R, Rice, S, Olivi, A, Kim, D, Rigamonti, D, Naff, N, Hemstreet, M, Berkow, L, Chery, P, Ulatowski, J, Moore, L, Cunningham, T, McBee, N, Hartman, T, Heidler, J, Hillis, A, Tuffiash, E, Chase, C, Kane, A, Greene-Chandos, D, Torbey, M, Ziai, W, Lane, K, Bhardwaj, A, Subhas, N, Mayberg, M, Beven, M, Rasmussen, P, Woo, H, Bhatia, S, Ebrahim, Z, Lotto, M, Vasarhelyi, F, Munis, J, Graves, K, Woletz, J, Chelune, G, Samples, S, Evans, J, Blair, D, Abou-Chebl, A, Shutway, F, Manke, D, Beven, C, Fogarty-Mack, P, Stieg, P, Eliazo, R, Li, P, Riina, H, Lien, C, Ravdin, L, Wang, J, Kuo, Y, Jaffe, R, Steinberg, G, Luu, D, Chang, S, Giffard, R, Lemmens, H, Morgan, R, Mathur, A, Angst, M, Meyer, A, Yi, H, Karzmark, P, Bell-Stephens, T, Marcellus, M, Sneyd, J, Pobereskin, L, Salsbury, S, Whitfield, P, Sawyer, R, Dashfield, A, Struthers, R, Davies, P, Rushton, A, Petty, V, Harding, S, Richardson, E, Yonas, H, Gyulai, F, Kirby, L, Kassam, A, Bircher, N, Meng, L, Krugh, J, Seever, G, Hendrickson, R, Gebel, J, Cowie, D, Fabinyi, G, Poustie, S, Davis, G, Drnda, A, Chandrasekara, D, Sturm, J, Phan, T, Shelton, A, Clausen, M, Micallef, S, Sills, A, Steinman, F, Sutton, P, Sanders, J, Van Alstine, D, Leggett, D, Cunningham, E, Hamm, W, Frankel, B, Sorenson, J, Atkins, L, Redmond, A, Dalrymple, S, Black, S, Fisher, W, Hall, C, Wilhite, D, Moore, T, Blanton, P, Sha, Z, Szmuk, P, Kim, D, Ashtari, A, Hagberg, C, Matuszczak, M, Shahen, A, Moise, O, Novy, D, Govindaraj, R, Jameson, L, Breeze, R, Awad, I, Mattison, R, Anderson, T, Salvia, L, Mosier, M, Smith, J, Lilley, W, White, B & Lenaerts, M 2009, 'Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage', Neurosurgery, vol. 64, no. 5, pp. 897-908. https://doi.org/10.1227/01.NEU.0000341903.11527.2F
Todd, Michael M. ; Hindman, Bradley J. ; Clarke, William R. ; Torner, James C. ; Weeks, Julie B. ; Bayman, Emine O. ; Shi, Qian ; Spofford, Christina M. ; Chaloner, K. ; Davis, P. ; Howard, M. ; Tranel, D. ; Moss, L. ; Winn, J. ; Wichman, M. ; Peters, R. ; Hansen, M. ; Anderson, D. ; Lang, J. ; Yoo, B. ; Adams, H. ; Clifton, G. ; Gelb, A. ; Loftus, C. ; Warner, D. ; Young, W. ; Frankowski, R. ; Kieburtz, K. ; Prough, D. ; Sternau, L. ; Marler, J. ; Moy, C. ; Radziszewska, B. ; Matta, B. ; Kirkpatrick, P. ; Chatfield, D. ; Skilbeck, C. ; Kirollos, R. ; Rasulo, F. ; English, K. ; Duffy, C. ; Pedersen, K. ; Scurrah, N. ; Burnstein, R. ; Prabhu, A. ; Salmond, C. ; Blackwell, A. ; Birrell, J. ; Jackson, S. ; Kassell, N. ; Pajewski, T. ; Fraley, H. ; Morris, A. ; Alden, T. ; Shaffrey, M. ; Bogdonoff, D. ; Durieux, M. ; Zuo, Z. ; Littlewood, K. ; Nemergut, E. ; Bedford, R. ; Stone, D. ; Balestrieri, P. ; Mason, J. ; Henry, G. ; Ting, P. ; Shafer, J. ; Blount, T. ; Kim, L. ; James, A. ; Farace, E. ; Clark, L. ; Irons, M. ; Sasaki, T. ; Webb, K. ; Short, T. ; Mee, E. ; Ormrod, J. ; Jane, J. ; Alden, T. ; Heppner, P. ; Olson, S. ; Ellegala, D. ; Lind, C. ; Sheehan, J. ; Woodfield, M. ; Law, A. ; Harrison, M. ; Davies, P. ; Campbell, D. ; Robertson, N. ; Fry, R. ; Sage, D. ; Laurent, S. ; Bradfield, C. ; Pedersen, K. ; Smith, K. ; Young, Y. ; Chambers, C. ; Hodkinson, B. ; Biddulph, J. ; Jensen, L. ; Ogden, J. ; Thayer, Z. ; Lee, F. ; Crump, S. ; Quaedackers, J. ; Wray, A. ; Roelfsema, V. ; Greif, R. ; Kleinpeter, G. ; Lothaller, C. ; Knosp, E. ; Pfisterer, W. ; Schatzer, R. ; Salem, C. ; Kutalek, W. ; Tuerkkan, E. ; Koller, L. ; Weber, T. ; Buchmann, A. ; Merhaut, C. ; Graf, M. ; Rapf, B. ; Lam, A. ; Newell, D. ; Tanzi, P. ; Lee, L. ; Domino, K. ; Vavilala, M. ; Bramhall, J. ; Souter, M. ; Britz, G. ; Winn, H. ; Bybee, H. ; Costello, T. ; Murphy, M. ; Harris, K. ; Thien, C. ; Nye, D. ; Han, T. ; McNeill, P. ; O'Brien, B. ; Cormack, J. ; Wyss, A. ; Grauer, R. ; Popovic, R. ; Jones, S. ; Deam, R. ; Heard, G. ; Watson, R. ; Evered, L. ; Bardenhagen, F. ; Meade, C. ; Haartsen, J. ; Kruger, J. ; Wilson, M. ; Maktabi, M. ; Traynelis, V. ; McAllister, A. ; Leonard, P. ; Hindman, B. ; Brian, J. ; Mensink, F. ; From, R. ; Papworth, D. ; Schmid, P. ; Dehring, D. ; Hitchon, P. ; VanGilder, J. ; Weeks, J. ; Manzel, K. ; Anderson, S. ; Tack, R. ; Taggard, D. ; Lennarson, P. ; Menhusen, M. ; Lownie, S. ; Craen, R. ; Novick, T. ; Ferguson, G. ; Duggal, N. ; Findlay, J. ; Ng, W. ; Cowie, D. ; Badner, N. ; Herrick, I. ; Smith, H. ; Heard, G. ; Peterson, R. ; Howell, J. ; Lindsey, L. ; Carriere, L. ; von Lewinski, M. ; Schaefer, B. ; Bisnaire, D. ; Doyle-Pettypiece, P. ; McTaggart, M. ; Giannotta, S. ; Zelman, V. ; Thomson, E. ; Babayan, E. ; McCleary, C. ; Fishback, D. ; Samra, S. ; Thompson, B. ; Chandler, W. ; Mcgillicuddy, J. ; Tremper, K. ; Turner, C. ; Smythe, P. ; Dy, E. ; Pai, S. ; Portman, V. ; Palmisano, J. ; Auer, D. ; Quigley, M. ; Giordani, B. ; Freymuth, A. ; Scott, P. ; Silbergleit, R. ; Hickenbottom, S. ; Litt, L. ; Lawton, M. ; Hannegan, L. ; Gupta, D. ; Bickler, P. ; Dodson, B. ; Talke, P. ; Rampil, I. ; Chen, B. ; Wright, P. ; Mitchell, J. ; Ryan, S. ; Walker, J. ; Quinnine, N. ; Applebury, C. ; Myles, P. ; Rosenfeld, J. ; Hunt, J. ; Wallace, S. ; D'Urso, P. ; Thien, C. ; McMahon, J. ; Wadanamby, S. ; Siu, K. ; Malham, G. ; Laidlaw, J. ; Salerno, S. ; Alatakis, S. ; Madder, H. ; Cairo, S. ; Konstantatos, A. ; Smart, J. ; Lindholm, D. ; Bain, D. ; Machlin, H. ; Moloney, J. ; Buckland, M. ; Silvers, A. ; Downey, G. ; Molnar, A. ; Langley, M. ; McIlroy, D. ; Daly, D. ; Bennett, P. ; Forlano, L. ; Testa, R. ; Burnett, W. ; Johnson, F. ; Angliss, M. ; Fletcher, H. ; Manninen, P. ; Wallace, M. ; Lukitto, K. ; Tymianski, M. ; Porter, P. ; Gentili, F. ; El-Beheiry, H. ; Mosa, M. ; Mak, P. ; Balki, M. ; Shaikh, S. ; Sawyer, R. ; Quader, K. ; Chelliah, R. ; Berklayd, P. ; Merah, N. ; Ghazali, G. ; McAndrews, M. ; Ridgley, J. ; Odukoya, O. ; Yantha, S. ; Wilson, J. ; Petrozza, P. ; Miller, C. ; O'Brien, K. ; Tong, C. ; Olympio, M. ; Reynolds, J. ; Colonna, D. ; Glazier, S. ; Nobles, S. ; Hill, D. ; Hulbert, H. ; Jenkins, W. ; Lanier, W. ; Piepgras, D. ; Wilson, R. ; Meyer, F. ; Atkinson, J. ; Link, M. ; Weglinski, M. ; Berge, K. ; McGregor, D. ; Trenerry, M. ; Smith, G. ; Walkes, J. ; Felmlee-Devine, M. ; Van Aken, H. ; Greiner, C. ; Freise, H. ; Brors, H. ; Hahnenkamp, K. ; Monteirode Oliveira, N. ; Schul, C. ; Moskopp, D. ; Woelfer, J. ; Hoenemann, C. ; Gramke, H. ; Bone, H. ; Gibmeier, I. ; Wirtz, S. ; Lohmann, H. ; Freyhoff, J. ; Bauer, B. ; Hogan, K. ; Dempsey, R. ; Rusy, D. ; Badie, B. ; Iskandar, B. ; Resnick, D. ; Deshmukh, P. ; Fitzpatrick, J. ; Sasse, F. ; Broderick, T. ; Willmann, K. ; Connery, L. ; Kish, J. ; Weasler, C. ; Page, N. ; Hermann, B. ; Jones, J. ; Dulli, D. ; Stanko, H. ; Geraghty, M. ; Elbe, R. ; Saleversusky, F. ; Leblanc, R. ; Lapointe, N. ; Macgregor, H. ; Sinclair, D. ; Sirhan, D. ; Maleki, M. ; Abou-Madi, M. ; Chartrand, D. ; Angle, M. ; Milovan, D. ; Painchaud, Y. ; Mirski, M. ; Tamargo, R. ; Rice, S. ; Olivi, A. ; Kim, D. ; Rigamonti, D. ; Naff, N. ; Hemstreet, M. ; Berkow, L. ; Chery, P. ; Ulatowski, J. ; Moore, L. ; Cunningham, T. ; McBee, N. ; Hartman, T. ; Heidler, J. ; Hillis, A. ; Tuffiash, E. ; Chase, C. ; Kane, A. ; Greene-Chandos, D. ; Torbey, M. ; Ziai, W. ; Lane, K. ; Bhardwaj, A. ; Subhas, N. ; Mayberg, M. ; Beven, M. ; Rasmussen, P. ; Woo, H. ; Bhatia, S. ; Ebrahim, Z. ; Lotto, M. ; Vasarhelyi, F. ; Munis, J. ; Graves, K. ; Woletz, J. ; Chelune, G. ; Samples, S. ; Evans, J. ; Blair, D. ; Abou-Chebl, A. ; Shutway, F. ; Manke, D. ; Beven, C. ; Fogarty-Mack, P. ; Stieg, P. ; Eliazo, R. ; Li, P. ; Riina, H. ; Lien, C. ; Ravdin, L. ; Wang, J. ; Kuo, Y. ; Jaffe, R. ; Steinberg, G. ; Luu, D. ; Chang, S. ; Giffard, R. ; Lemmens, H. ; Morgan, R. ; Mathur, A. ; Angst, M. ; Meyer, A. ; Yi, H. ; Karzmark, P. ; Bell-Stephens, T. ; Marcellus, M. ; Sneyd, J. ; Pobereskin, L. ; Salsbury, S. ; Whitfield, P. ; Sawyer, R. ; Dashfield, A. ; Struthers, R. ; Davies, P. ; Rushton, A. ; Petty, V. ; Harding, S. ; Richardson, E. ; Yonas, H. ; Gyulai, F. ; Kirby, L. ; Kassam, A. ; Bircher, N. ; Meng, L. ; Krugh, J. ; Seever, G. ; Hendrickson, R. ; Gebel, J. ; Cowie, D. ; Fabinyi, G. ; Poustie, S. ; Davis, G. ; Drnda, A. ; Chandrasekara, D. ; Sturm, J. ; Phan, T. ; Shelton, A. ; Clausen, M. ; Micallef, S. ; Sills, A. ; Steinman, F. ; Sutton, P. ; Sanders, J. ; Van Alstine, D. ; Leggett, D. ; Cunningham, E. ; Hamm, W. ; Frankel, B. ; Sorenson, J. ; Atkins, L. ; Redmond, A. ; Dalrymple, S. ; Black, S. ; Fisher, W. ; Hall, C. ; Wilhite, D. ; Moore, T. ; Blanton, P. ; Sha, Z. ; Szmuk, P. ; Kim, D. ; Ashtari, A. ; Hagberg, C. ; Matuszczak, M. ; Shahen, A. ; Moise, O. ; Novy, D. ; Govindaraj, R. ; Jameson, L. ; Breeze, R. ; Awad, I. ; Mattison, R. ; Anderson, T. ; Salvia, L. ; Mosier, M. ; Smith, J. ; Lilley, W. ; White, B. ; Lenaerts, M. / Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage. In: Neurosurgery. 2009 ; Vol. 64, No. 5. pp. 897-908.
@article{019bacc456a04ac780fa9a7780ade278,
title = "Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage",
abstract = "OBJECTIVE:We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36°C-37°C) or hypothermia (32.5°C-33.5°C). Fever (≥38.5°C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41{\%} of patients. In 97{\%} of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever- related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.",
keywords = "Clinical trial, Fever, Infection, Postoperative care, Subarachnoid hemorrhage",
author = "Todd, {Michael M.} and Hindman, {Bradley J.} and Clarke, {William R.} and Torner, {James C.} and Weeks, {Julie B.} and Bayman, {Emine O.} and Qian Shi and Spofford, {Christina M.} and K. Chaloner and P. Davis and M. Howard and D. Tranel and L. Moss and J. Winn and M. Wichman and R. Peters and M. Hansen and D. Anderson and J. Lang and B. Yoo and H. Adams and G. Clifton and A. Gelb and C. Loftus and D. Warner and W. Young and R. Frankowski and K. Kieburtz and D. Prough and L. Sternau and J. Marler and C. Moy and B. Radziszewska and B. Matta and P. Kirkpatrick and D. Chatfield and C. Skilbeck and R. Kirollos and F. Rasulo and K. English and C. Duffy and K. Pedersen and N. Scurrah and R. Burnstein and A. Prabhu and C. Salmond and A. Blackwell and J. Birrell and S. Jackson and N. Kassell and T. Pajewski and H. Fraley and A. Morris and T. Alden and M. Shaffrey and D. Bogdonoff and M. Durieux and Z. Zuo and K. Littlewood and E. Nemergut and R. Bedford and D. Stone and P. Balestrieri and J. Mason and G. Henry and P. Ting and J. Shafer and T. Blount and L. Kim and A. James and E. Farace and L. Clark and M. Irons and T. Sasaki and K. Webb and T. Short and E. Mee and J. Ormrod and J. Jane and T. Alden and P. Heppner and S. Olson and D. Ellegala and C. Lind and J. Sheehan and M. Woodfield and A. Law and M. Harrison and P. Davies and D. Campbell and N. Robertson and R. Fry and D. Sage and S. Laurent and C. Bradfield and K. Pedersen and K. Smith and Y. Young and C. Chambers and B. Hodkinson and J. Biddulph and L. Jensen and J. Ogden and Z. Thayer and F. Lee and S. Crump and J. Quaedackers and A. Wray and V. Roelfsema and R. Greif and G. Kleinpeter and C. Lothaller and E. Knosp and W. Pfisterer and R. Schatzer and C. Salem and W. Kutalek and E. Tuerkkan and L. Koller and T. Weber and A. Buchmann and C. Merhaut and M. Graf and B. Rapf and A. Lam and D. Newell and P. Tanzi and L. Lee and K. Domino and M. Vavilala and J. Bramhall and M. Souter and G. Britz and H. Winn and H. Bybee and T. Costello and M. Murphy and K. Harris and C. Thien and D. Nye and T. Han and P. McNeill and B. O'Brien and J. Cormack and A. Wyss and R. Grauer and R. Popovic and S. Jones and R. Deam and G. Heard and R. Watson and L. Evered and F. Bardenhagen and C. Meade and J. Haartsen and J. Kruger and M. Wilson and M. Maktabi and V. Traynelis and A. McAllister and P. Leonard and B. Hindman and J. Brian and F. Mensink and R. From and D. Papworth and P. Schmid and D. Dehring and P. Hitchon and J. VanGilder and J. Weeks and K. Manzel and S. Anderson and R. Tack and D. Taggard and P. Lennarson and M. Menhusen and S. Lownie and R. Craen and T. Novick and G. Ferguson and N. Duggal and J. Findlay and W. Ng and D. Cowie and N. Badner and I. Herrick and H. Smith and G. Heard and R. Peterson and J. Howell and L. Lindsey and L. Carriere and {von Lewinski}, M. and B. Schaefer and D. Bisnaire and P. Doyle-Pettypiece and M. McTaggart and S. Giannotta and V. Zelman and E. Thomson and E. Babayan and C. McCleary and D. Fishback and S. Samra and B. Thompson and W. Chandler and J. Mcgillicuddy and K. Tremper and C. Turner and P. Smythe and E. Dy and S. Pai and V. Portman and J. Palmisano and D. Auer and M. Quigley and B. Giordani and A. Freymuth and P. Scott and R. Silbergleit and S. Hickenbottom and L. Litt and M. Lawton and L. Hannegan and D. Gupta and P. Bickler and B. Dodson and P. Talke and I. Rampil and B. Chen and P. Wright and J. Mitchell and S. Ryan and J. Walker and N. Quinnine and C. Applebury and P. Myles and J. Rosenfeld and J. Hunt and S. Wallace and P. D'Urso and C. Thien and J. McMahon and S. Wadanamby and K. Siu and G. Malham and J. Laidlaw and S. Salerno and S. Alatakis and H. Madder and S. Cairo and A. Konstantatos and J. Smart and D. Lindholm and D. Bain and H. Machlin and J. Moloney and M. Buckland and A. Silvers and G. Downey and A. Molnar and M. Langley and D. McIlroy and D. Daly and P. Bennett and L. Forlano and R. Testa and W. Burnett and F. Johnson and M. Angliss and H. Fletcher and P. Manninen and M. Wallace and K. Lukitto and M. Tymianski and P. Porter and F. Gentili and H. El-Beheiry and M. Mosa and P. Mak and M. Balki and S. Shaikh and R. Sawyer and K. Quader and R. Chelliah and P. Berklayd and N. Merah and G. Ghazali and M. McAndrews and J. Ridgley and O. Odukoya and S. Yantha and J. Wilson and P. Petrozza and C. Miller and K. O'Brien and C. Tong and M. Olympio and J. Reynolds and D. Colonna and S. Glazier and S. Nobles and D. Hill and H. Hulbert and W. Jenkins and W. Lanier and D. Piepgras and R. Wilson and F. Meyer and J. Atkinson and M. Link and M. Weglinski and K. Berge and D. McGregor and M. Trenerry and G. Smith and J. Walkes and M. Felmlee-Devine and {Van Aken}, H. and C. Greiner and H. Freise and H. Brors and K. Hahnenkamp and {Monteirode Oliveira}, N. and C. Schul and D. Moskopp and J. Woelfer and C. Hoenemann and H. Gramke and H. Bone and I. Gibmeier and S. Wirtz and H. Lohmann and J. Freyhoff and B. Bauer and K. Hogan and R. Dempsey and D. Rusy and B. Badie and B. Iskandar and D. Resnick and P. Deshmukh and J. Fitzpatrick and F. Sasse and T. Broderick and K. Willmann and L. Connery and J. Kish and C. Weasler and N. Page and B. Hermann and J. Jones and D. Dulli and H. Stanko and M. Geraghty and R. Elbe and F. Saleversusky and R. Leblanc and N. Lapointe and H. Macgregor and D. Sinclair and D. Sirhan and M. Maleki and M. Abou-Madi and D. Chartrand and M. Angle and D. Milovan and Y. Painchaud and M. Mirski and R. Tamargo and S. Rice and A. Olivi and D. Kim and D. Rigamonti and N. Naff and M. Hemstreet and L. Berkow and P. Chery and J. Ulatowski and L. Moore and T. Cunningham and N. McBee and T. Hartman and J. Heidler and A. Hillis and E. Tuffiash and C. Chase and A. Kane and D. Greene-Chandos and M. Torbey and W. Ziai and K. Lane and A. Bhardwaj and N. Subhas and M. Mayberg and M. Beven and P. Rasmussen and H. Woo and S. Bhatia and Z. Ebrahim and M. Lotto and F. Vasarhelyi and J. Munis and K. Graves and J. Woletz and G. Chelune and S. Samples and J. Evans and D. Blair and A. Abou-Chebl and F. Shutway and D. Manke and C. Beven and P. Fogarty-Mack and P. Stieg and R. Eliazo and P. Li and H. Riina and C. Lien and L. Ravdin and J. Wang and Y. Kuo and R. Jaffe and G. Steinberg and D. Luu and S. Chang and R. Giffard and H. Lemmens and R. Morgan and A. Mathur and M. Angst and A. Meyer and H. Yi and P. Karzmark and T. Bell-Stephens and M. Marcellus and J. Sneyd and L. Pobereskin and S. Salsbury and P. Whitfield and R. Sawyer and A. Dashfield and R. Struthers and P. Davies and A. Rushton and V. Petty and S. Harding and E. Richardson and H. Yonas and F. Gyulai and L. Kirby and A. Kassam and N. Bircher and L. Meng and J. Krugh and G. Seever and R. Hendrickson and J. Gebel and D. Cowie and G. Fabinyi and S. Poustie and G. Davis and A. Drnda and D. Chandrasekara and J. Sturm and T. Phan and A. Shelton and M. Clausen and S. Micallef and A. Sills and F. Steinman and P. Sutton and J. Sanders and {Van Alstine}, D. and D. Leggett and E. Cunningham and W. Hamm and B. Frankel and J. Sorenson and L. Atkins and A. Redmond and S. Dalrymple and S. Black and W. Fisher and C. Hall and D. Wilhite and T. Moore and P. Blanton and Z. Sha and P. Szmuk and D. Kim and A. Ashtari and C. Hagberg and M. Matuszczak and A. Shahen and O. Moise and D. Novy and R. Govindaraj and L. Jameson and R. Breeze and I. Awad and R. Mattison and T. Anderson and L. Salvia and M. Mosier and J. Smith and W. Lilley and B. White and M. Lenaerts",
year = "2009",
month = "5",
doi = "10.1227/01.NEU.0000341903.11527.2F",
language = "English (US)",
volume = "64",
pages = "897--908",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage

AU - Todd, Michael M.

AU - Hindman, Bradley J.

AU - Clarke, William R.

AU - Torner, James C.

AU - Weeks, Julie B.

AU - Bayman, Emine O.

AU - Shi, Qian

AU - Spofford, Christina M.

AU - Chaloner, K.

AU - Davis, P.

AU - Howard, M.

AU - Tranel, D.

AU - Moss, L.

AU - Winn, J.

AU - Wichman, M.

AU - Peters, R.

AU - Hansen, M.

AU - Anderson, D.

AU - Lang, J.

AU - Yoo, B.

AU - Adams, H.

AU - Clifton, G.

AU - Gelb, A.

AU - Loftus, C.

AU - Warner, D.

AU - Young, W.

AU - Frankowski, R.

AU - Kieburtz, K.

AU - Prough, D.

AU - Sternau, L.

AU - Marler, J.

AU - Moy, C.

AU - Radziszewska, B.

AU - Matta, B.

AU - Kirkpatrick, P.

AU - Chatfield, D.

AU - Skilbeck, C.

AU - Kirollos, R.

AU - Rasulo, F.

AU - English, K.

AU - Duffy, C.

AU - Pedersen, K.

AU - Scurrah, N.

AU - Burnstein, R.

AU - Prabhu, A.

AU - Salmond, C.

AU - Blackwell, A.

AU - Birrell, J.

AU - Jackson, S.

AU - Kassell, N.

AU - Pajewski, T.

AU - Fraley, H.

AU - Morris, A.

AU - Alden, T.

AU - Shaffrey, M.

AU - Bogdonoff, D.

AU - Durieux, M.

AU - Zuo, Z.

AU - Littlewood, K.

AU - Nemergut, E.

AU - Bedford, R.

AU - Stone, D.

AU - Balestrieri, P.

AU - Mason, J.

AU - Henry, G.

AU - Ting, P.

AU - Shafer, J.

AU - Blount, T.

AU - Kim, L.

AU - James, A.

AU - Farace, E.

AU - Clark, L.

AU - Irons, M.

AU - Sasaki, T.

AU - Webb, K.

AU - Short, T.

AU - Mee, E.

AU - Ormrod, J.

AU - Jane, J.

AU - Alden, T.

AU - Heppner, P.

AU - Olson, S.

AU - Ellegala, D.

AU - Lind, C.

AU - Sheehan, J.

AU - Woodfield, M.

AU - Law, A.

AU - Harrison, M.

AU - Davies, P.

AU - Campbell, D.

AU - Robertson, N.

AU - Fry, R.

AU - Sage, D.

AU - Laurent, S.

AU - Bradfield, C.

AU - Pedersen, K.

AU - Smith, K.

AU - Young, Y.

AU - Chambers, C.

AU - Hodkinson, B.

AU - Biddulph, J.

AU - Jensen, L.

AU - Ogden, J.

AU - Thayer, Z.

AU - Lee, F.

AU - Crump, S.

AU - Quaedackers, J.

AU - Wray, A.

AU - Roelfsema, V.

AU - Greif, R.

AU - Kleinpeter, G.

AU - Lothaller, C.

AU - Knosp, E.

AU - Pfisterer, W.

AU - Schatzer, R.

AU - Salem, C.

AU - Kutalek, W.

AU - Tuerkkan, E.

AU - Koller, L.

AU - Weber, T.

AU - Buchmann, A.

AU - Merhaut, C.

AU - Graf, M.

AU - Rapf, B.

AU - Lam, A.

AU - Newell, D.

AU - Tanzi, P.

AU - Lee, L.

AU - Domino, K.

AU - Vavilala, M.

AU - Bramhall, J.

AU - Souter, M.

AU - Britz, G.

AU - Winn, H.

AU - Bybee, H.

AU - Costello, T.

AU - Murphy, M.

AU - Harris, K.

AU - Thien, C.

AU - Nye, D.

AU - Han, T.

AU - McNeill, P.

AU - O'Brien, B.

AU - Cormack, J.

AU - Wyss, A.

AU - Grauer, R.

AU - Popovic, R.

AU - Jones, S.

AU - Deam, R.

AU - Heard, G.

AU - Watson, R.

AU - Evered, L.

AU - Bardenhagen, F.

AU - Meade, C.

AU - Haartsen, J.

AU - Kruger, J.

AU - Wilson, M.

AU - Maktabi, M.

AU - Traynelis, V.

AU - McAllister, A.

AU - Leonard, P.

AU - Hindman, B.

AU - Brian, J.

AU - Mensink, F.

AU - From, R.

AU - Papworth, D.

AU - Schmid, P.

AU - Dehring, D.

AU - Hitchon, P.

AU - VanGilder, J.

AU - Weeks, J.

AU - Manzel, K.

AU - Anderson, S.

AU - Tack, R.

AU - Taggard, D.

AU - Lennarson, P.

AU - Menhusen, M.

AU - Lownie, S.

AU - Craen, R.

AU - Novick, T.

AU - Ferguson, G.

AU - Duggal, N.

AU - Findlay, J.

AU - Ng, W.

AU - Cowie, D.

AU - Badner, N.

AU - Herrick, I.

AU - Smith, H.

AU - Heard, G.

AU - Peterson, R.

AU - Howell, J.

AU - Lindsey, L.

AU - Carriere, L.

AU - von Lewinski, M.

AU - Schaefer, B.

AU - Bisnaire, D.

AU - Doyle-Pettypiece, P.

AU - McTaggart, M.

AU - Giannotta, S.

AU - Zelman, V.

AU - Thomson, E.

AU - Babayan, E.

AU - McCleary, C.

AU - Fishback, D.

AU - Samra, S.

AU - Thompson, B.

AU - Chandler, W.

AU - Mcgillicuddy, J.

AU - Tremper, K.

AU - Turner, C.

AU - Smythe, P.

AU - Dy, E.

AU - Pai, S.

AU - Portman, V.

AU - Palmisano, J.

AU - Auer, D.

AU - Quigley, M.

AU - Giordani, B.

AU - Freymuth, A.

AU - Scott, P.

AU - Silbergleit, R.

AU - Hickenbottom, S.

AU - Litt, L.

AU - Lawton, M.

AU - Hannegan, L.

AU - Gupta, D.

AU - Bickler, P.

AU - Dodson, B.

AU - Talke, P.

AU - Rampil, I.

AU - Chen, B.

AU - Wright, P.

AU - Mitchell, J.

AU - Ryan, S.

AU - Walker, J.

AU - Quinnine, N.

AU - Applebury, C.

AU - Myles, P.

AU - Rosenfeld, J.

AU - Hunt, J.

AU - Wallace, S.

AU - D'Urso, P.

AU - Thien, C.

AU - McMahon, J.

AU - Wadanamby, S.

AU - Siu, K.

AU - Malham, G.

AU - Laidlaw, J.

AU - Salerno, S.

AU - Alatakis, S.

AU - Madder, H.

AU - Cairo, S.

AU - Konstantatos, A.

AU - Smart, J.

AU - Lindholm, D.

AU - Bain, D.

AU - Machlin, H.

AU - Moloney, J.

AU - Buckland, M.

AU - Silvers, A.

AU - Downey, G.

AU - Molnar, A.

AU - Langley, M.

AU - McIlroy, D.

AU - Daly, D.

AU - Bennett, P.

AU - Forlano, L.

AU - Testa, R.

AU - Burnett, W.

AU - Johnson, F.

AU - Angliss, M.

AU - Fletcher, H.

AU - Manninen, P.

AU - Wallace, M.

AU - Lukitto, K.

AU - Tymianski, M.

AU - Porter, P.

AU - Gentili, F.

AU - El-Beheiry, H.

AU - Mosa, M.

AU - Mak, P.

AU - Balki, M.

AU - Shaikh, S.

AU - Sawyer, R.

AU - Quader, K.

AU - Chelliah, R.

AU - Berklayd, P.

AU - Merah, N.

AU - Ghazali, G.

AU - McAndrews, M.

AU - Ridgley, J.

AU - Odukoya, O.

AU - Yantha, S.

AU - Wilson, J.

AU - Petrozza, P.

AU - Miller, C.

AU - O'Brien, K.

AU - Tong, C.

AU - Olympio, M.

AU - Reynolds, J.

AU - Colonna, D.

AU - Glazier, S.

AU - Nobles, S.

AU - Hill, D.

AU - Hulbert, H.

AU - Jenkins, W.

AU - Lanier, W.

AU - Piepgras, D.

AU - Wilson, R.

AU - Meyer, F.

AU - Atkinson, J.

AU - Link, M.

AU - Weglinski, M.

AU - Berge, K.

AU - McGregor, D.

AU - Trenerry, M.

AU - Smith, G.

AU - Walkes, J.

AU - Felmlee-Devine, M.

AU - Van Aken, H.

AU - Greiner, C.

AU - Freise, H.

AU - Brors, H.

AU - Hahnenkamp, K.

AU - Monteirode Oliveira, N.

AU - Schul, C.

AU - Moskopp, D.

AU - Woelfer, J.

AU - Hoenemann, C.

AU - Gramke, H.

AU - Bone, H.

AU - Gibmeier, I.

AU - Wirtz, S.

AU - Lohmann, H.

AU - Freyhoff, J.

AU - Bauer, B.

AU - Hogan, K.

AU - Dempsey, R.

AU - Rusy, D.

AU - Badie, B.

AU - Iskandar, B.

AU - Resnick, D.

AU - Deshmukh, P.

AU - Fitzpatrick, J.

AU - Sasse, F.

AU - Broderick, T.

AU - Willmann, K.

AU - Connery, L.

AU - Kish, J.

AU - Weasler, C.

AU - Page, N.

AU - Hermann, B.

AU - Jones, J.

AU - Dulli, D.

AU - Stanko, H.

AU - Geraghty, M.

AU - Elbe, R.

AU - Saleversusky, F.

AU - Leblanc, R.

AU - Lapointe, N.

AU - Macgregor, H.

AU - Sinclair, D.

AU - Sirhan, D.

AU - Maleki, M.

AU - Abou-Madi, M.

AU - Chartrand, D.

AU - Angle, M.

AU - Milovan, D.

AU - Painchaud, Y.

AU - Mirski, M.

AU - Tamargo, R.

AU - Rice, S.

AU - Olivi, A.

AU - Kim, D.

AU - Rigamonti, D.

AU - Naff, N.

AU - Hemstreet, M.

AU - Berkow, L.

AU - Chery, P.

AU - Ulatowski, J.

AU - Moore, L.

AU - Cunningham, T.

AU - McBee, N.

AU - Hartman, T.

AU - Heidler, J.

AU - Hillis, A.

AU - Tuffiash, E.

AU - Chase, C.

AU - Kane, A.

AU - Greene-Chandos, D.

AU - Torbey, M.

AU - Ziai, W.

AU - Lane, K.

AU - Bhardwaj, A.

AU - Subhas, N.

AU - Mayberg, M.

AU - Beven, M.

AU - Rasmussen, P.

AU - Woo, H.

AU - Bhatia, S.

AU - Ebrahim, Z.

AU - Lotto, M.

AU - Vasarhelyi, F.

AU - Munis, J.

AU - Graves, K.

AU - Woletz, J.

AU - Chelune, G.

AU - Samples, S.

AU - Evans, J.

AU - Blair, D.

AU - Abou-Chebl, A.

AU - Shutway, F.

AU - Manke, D.

AU - Beven, C.

AU - Fogarty-Mack, P.

AU - Stieg, P.

AU - Eliazo, R.

AU - Li, P.

AU - Riina, H.

AU - Lien, C.

AU - Ravdin, L.

AU - Wang, J.

AU - Kuo, Y.

AU - Jaffe, R.

AU - Steinberg, G.

AU - Luu, D.

AU - Chang, S.

AU - Giffard, R.

AU - Lemmens, H.

AU - Morgan, R.

AU - Mathur, A.

AU - Angst, M.

AU - Meyer, A.

AU - Yi, H.

AU - Karzmark, P.

AU - Bell-Stephens, T.

AU - Marcellus, M.

AU - Sneyd, J.

AU - Pobereskin, L.

AU - Salsbury, S.

AU - Whitfield, P.

AU - Sawyer, R.

AU - Dashfield, A.

AU - Struthers, R.

AU - Davies, P.

AU - Rushton, A.

AU - Petty, V.

AU - Harding, S.

AU - Richardson, E.

AU - Yonas, H.

AU - Gyulai, F.

AU - Kirby, L.

AU - Kassam, A.

AU - Bircher, N.

AU - Meng, L.

AU - Krugh, J.

AU - Seever, G.

AU - Hendrickson, R.

AU - Gebel, J.

AU - Cowie, D.

AU - Fabinyi, G.

AU - Poustie, S.

AU - Davis, G.

AU - Drnda, A.

AU - Chandrasekara, D.

AU - Sturm, J.

AU - Phan, T.

AU - Shelton, A.

AU - Clausen, M.

AU - Micallef, S.

AU - Sills, A.

AU - Steinman, F.

AU - Sutton, P.

AU - Sanders, J.

AU - Van Alstine, D.

AU - Leggett, D.

AU - Cunningham, E.

AU - Hamm, W.

AU - Frankel, B.

AU - Sorenson, J.

AU - Atkins, L.

AU - Redmond, A.

AU - Dalrymple, S.

AU - Black, S.

AU - Fisher, W.

AU - Hall, C.

AU - Wilhite, D.

AU - Moore, T.

AU - Blanton, P.

AU - Sha, Z.

AU - Szmuk, P.

AU - Kim, D.

AU - Ashtari, A.

AU - Hagberg, C.

AU - Matuszczak, M.

AU - Shahen, A.

AU - Moise, O.

AU - Novy, D.

AU - Govindaraj, R.

AU - Jameson, L.

AU - Breeze, R.

AU - Awad, I.

AU - Mattison, R.

AU - Anderson, T.

AU - Salvia, L.

AU - Mosier, M.

AU - Smith, J.

AU - Lilley, W.

AU - White, B.

AU - Lenaerts, M.

PY - 2009/5

Y1 - 2009/5

N2 - OBJECTIVE:We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36°C-37°C) or hypothermia (32.5°C-33.5°C). Fever (≥38.5°C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever- related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

AB - OBJECTIVE:We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36°C-37°C) or hypothermia (32.5°C-33.5°C). Fever (≥38.5°C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever- related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

KW - Clinical trial

KW - Fever

KW - Infection

KW - Postoperative care

KW - Subarachnoid hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=67650733224&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650733224&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000341903.11527.2F

DO - 10.1227/01.NEU.0000341903.11527.2F

M3 - Article

VL - 64

SP - 897

EP - 908

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 5

ER -