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@ARTICLE{Wasilewski:301274,
      author       = {D. Wasilewski$^*$ and P. Truckenmueller and A. Früh and P.
                      Vajkoczy and S. Wolf},
      collaboration = {E. S. Group},
      title        = {{E}valuating extreme temperature values and patient
                      outcomes in aneurysmal subarachnoid hemorrhage: {P}ost-hoc
                      insights from the {E}arlydrain trial.},
      journal      = {Journal of critical care},
      volume       = {89},
      issn         = {0883-9441},
      address      = {[Amsterdam]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-00959},
      pages        = {155104},
      year         = {2025},
      abstract     = {Dysregulation of temperature in aneurysmal subarachnoid
                      hemorrhage (aSAH) patients may worsen neurological outcomes.
                      Fever and hypothermia could be related to infection,
                      inflammation, or loss of central temperature control.
                      However, longitudinal studies on temperature extremes and
                      outcomes are lacking. This post-hoc analysis of the
                      Earlydrain trial examines the prognostic significance of
                      body temperature during the first 8 days of neurocritical
                      care.We analyzed data from 287 patients, using Generalized
                      Estimating Equations to investigate clinically used
                      thresholds for intervention on body temperature. Statistical
                      models were adjusted for hemorrhage severity, age,
                      intracerebral and intraventricular hemorrhage, infection and
                      the use of a lumbar drainage. We assessed the impact of
                      different temperature thresholds on the modified Rankin
                      Scale (mRS) at 180 days and the incidence of secondary
                      infarctions.Extreme temperatures were associated with worse
                      180-day outcomes. In univariate analysis, all investigated
                      temperature thresholds (>38.0 °C, >38.2 °C, > 39.0 °C, as
                      well as <36.0 °C) were associated with worse outcome. In
                      multivariate analysis, temperatures above 39 °C and below
                      36 °C increased the odds of an unfavorable mRS >2 (ORadj =
                      2.60, p = 0.002 and ORadj = 3.82, p = 0.02, respectively).
                      The development of secondary infarctions was not
                      significantly related to temperature extremes.Extreme
                      temperature values significantly influence outcomes in aSAH.
                      Maintaining normothermia may improve prognosis, warranting
                      prospective studies for targeted temperature management.},
      keywords     = {Earlydrain (Other) / SAH (Other) / Secondary infarction
                      (Other) / Temperature (Other) / mRS (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40339312},
      doi          = {10.1016/j.jcrc.2025.155104},
      url          = {https://inrepo02.dkfz.de/record/301274},
}