Background and Purpose- In ischemic stroke, body temperature is associated with functional outcome. However, the relationship between temperature and outcome may differ in the intraischemic and postischemic phases of stroke. We aimed to determine whether body temperature before or after endovascular thrombectomy (EVT) for large vessel occlusion stroke is associated with clinical outcomes. Methods- Consecutive EVT patients were identified from a prospective registry. Temperature measurements within 24 hours of admission were stratified into pre-EVT (preprocedural and intraprocedural) and post-EVT measurements, which served as surrogates for the intraischemic and postischemic phases of large vessel occlusion stroke, respectively. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0, 1, or 2 at 3 months. Secondary outcomes included the ordinal shift of modified Rankin Scale scores at 3 months, symptomatic intracerebral hemorrhage, and mortality at 3 months. Results- Four hundred thirty-two participants were included (59% men, mean±SD age 65.6±15.7 years). Multivariable logistic regression demonstrated that higher median pre-EVT temperature (per 1°C increase) was an independent predictor of reduced functional independence (odds ratio [OR], 0.66 [95% CI, 0.46-0.94]; P=0.02), poorer modified Rankin Scale scores (common OR, 1.42 [95% CI, 1.08-1.85]; P=0.01), and increased mortality (OR, 1.65 [95% CI, 1.02-2.69]; P=0.04). Peak post-EVT temperature (per 1°C increase) was a significant predictor of elevated modified Rankin Scale scores (common OR, 1.39 [95% CI, 1.03-1.90]; P=0.03) and higher mortality (OR, 1.66 [95% CI, 1.04-2.67]; P=0.03). Conclusions- In patients with large vessel occlusion stroke treated with EVT, higher body temperatures during both the intraischemic and postischemic phases were associated with poorer clinical outcomes. Future research investigating the maintenance of normothermia or therapeutic hypothermia in patients needing to be transferred from primary to EVT-capable stroke centers could be considered.

中文翻译：

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血管内血栓切除术对大血管闭塞性卒中前后体温的影响。

背景与目的-在缺血性中风中，体温与功能预后相关。但是，在卒中的缺血内和缺血后阶段，温度与预后之间的关系可能有所不同。我们旨在确定大血管闭塞性卒中的血管内血栓切除术（EVT）之前或之后的体温是否与临床结局相关。方法-从前瞻性登记处确定连续EVT患者。入院24小时内的温度测量分为EVT前（过程前和过程内）和EVT后测量，分别用作大血管闭塞性卒中的缺血内和缺血后阶段的替代指标。主要结果是功能独立性，定义为3个月时改良的Rankin量表评分为0、1或2。次要结局包括改良的Rankin量表评分在3个月时的顺序变化，症状性脑出血和3个月时的死亡率。结果-包括342名参与者（男性59％，平均±SD年龄65.6±15.7岁）。多变量logistic回归表明，较高的EVT前中位温度（每升高1°C）是功能独立性降低的独立预测因子（优势比[OR]，0.66 [95％CI，0.46-0.94]； P = 0.02），较差改良的Rankin量表评分（常见OR，1.42 [95％CI，1.08-1.85]； P = 0.01）和死亡率增加（OR，1.65 [95％CI，1.02-2.69]； P = 0.04）。EVT后峰值温度（每升高1°C）是改良的Rankin量表评分升高的重要预测指标（普通OR，1.39 [95％CI，1.03-1.90]； P = 0.03）和较高的死亡率（OR，1.66 [95] ％CI，1.04-2.67]； P ＝ 0.03）。结论-在接受EVT治疗的大血管闭塞性卒中患者中，缺血期间和缺血后阶段的体温升高与较差的临床预后相关。可以考虑对需要从原发性心脏病中心转移至具有EVT的卒中中心的患者维持常温或低温治疗的未来研究。