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Neurology Research International
Volume 2012, Article ID 479865, 6 pages
http://dx.doi.org/10.1155/2012/479865
Clinical Study

Influence of Fever and Hospital-Acquired Infection on the Incidence of Delayed Neurological Deficit and Poor Outcome after Aneurysmal Subarachnoid Hemorrhage

1Department of Neurosurgery, Penn State Milton S. Hershey Medical Center and College of Medicine, Hershey, PA 17033, USA
2Penn State University College of Medicine, Hershey, PA 17033, USA
3Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
4Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA

Received 12 May 2012; Revised 3 August 2012; Accepted 4 September 2012

Academic Editor: Changiz Geula

Copyright © 2012 G. Logan Douds et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although fever and infection have been implicated in the causation of delayed neurological deficits (DND) and poor outcome after aneurysmal subarachnoid hemorrhage (SAH), the relationship between these two often related events has not been extensively studied. We reviewed these events through of our retrospective database of patients with SAH. Multivariate logistic regression was used to determine independent predictors of DND and poor outcome. A total of 186 patients were analyzed. DND was noted in 76 patients (45%). Fever was recorded in 102 patients (55%); infection was noted in 87 patients (47%). A patient with one infection was more likely to experience DND compared to a patient with no infections (adjusted OR 3.73, 95% CI 1.62, 8.59). For those with more than two infections the likelihood of DND was even greater (adjusted OR 4.24, 95% CI 1.55, 11.56). Patients with 1-2 days of fever were less likely to have a favorable outcome when compared to their counterparts with no fever (adjusted OR 0.19, 95% CI 0.06, 0.62). This trend worsened as the number of days febrile increased. These data suggest that the presence of infection is associated with DND, but that fever may have a stronger independent association with overall outcome.