Continuous temperature monitoring in patients with spontaneous intracerebral hemorrhage: insights into temperature patterns and variability.

Background: Spontaneous intracerebral hemorrhage (ICH) is frequently associated with autonomic nervous system dysfunction, potentially leading to temperature dysregulations.

Methods: This retrospective study analysis temperature and variability indices standard deviation (SD), coefficient of variation (CV) and successive variability (SV) continuously monitored over the first 96 hours post-admission in 261 ICH patients. Functional outcomes included the modified Rankin Scale (mRS) at discharge and 90-day follow-up.

Results: Elevated temperature occurred in 69 patients (26.4 %) and was associated with higher admission National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.003), early hematoma expansion (p = 0.012), longer ICU stays (p < 0.001), and worse functional outcomes at discharge (p = 0.039) and follow-up (p = 0.045). Patients with elevated temperature exhibited greater SD variability, while SV remained similar. Subgroups with intraventricular (p = 0.033), or larger hemorrhages (p = 0.019) were predisposed to elevated temperature and higher SD variability. Logistic regression revealed that younger age, lower premorbid mRS, and lower NIHSS at admission were significant predictors of good 90-day outcomes (e.g., OR 0.352, CI 0.226-0.548, p < 0.001 for premorbid mRS). Intraventricular hemorrhage significantly reduced the likelihood of recovery (OR 0.289, CI 0.123-0.682, p = 0.005 for 0-24 h). Elevated temperature showed a trend toward worse outcomes (OR 2.445, 95 %CI 0.994-6.011, p = 0.051), and increased temperature variability (SD) was independently associated with poor outcomes in the first 24 hours (OR 0.090, CI 0.009-0.956, p = 0.046).

Conclusions: Elevated temperature and early temperature variability within the first 24 hours are associated with worse functional outcomes in ICH patients, highlighting the importance of targeted thermoregulation strategies.