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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1381872
This article is part of the Research Topic Advances and controversies in ischemic stroke management: from prevention to diagnosis and acute treatment View all 64 articles

The effect of inadvertent systemic hypothermia after mechanical thrombectomy in patients with large vessel occlusion stroke

Provisionally accepted
Kristina auf dem Brinke Kristina auf dem Brinke 1*Fabian Kück Fabian Kück 2Ala Jamous Ala Jamous 3Marielle Ernst Marielle Ernst 3Nils Kunze-Szikszay Nils Kunze-Szikszay 4Marios N. Psychogios Marios N. Psychogios 5Ilko Maier Ilko Maier 1*
  • 1 Department of Neurology, University Medical Center Göttingen, Goettingen, Germany
  • 2 Institute of Medical Statistics, University Medical Center Göttingen, Göttingen, Lower Saxony, Germany
  • 3 Institute of Neuroradiology, University Medical Center Göttingen, Goettingen, Germany
  • 4 Department of Anesthesiology, University Medical Center Göttingen, Goettingen, Lower Saxony, Germany
  • 5 Division of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland

The final, formatted version of the article will be published soon.

    Postinterventional hypothermia is a frequent complication in patients with large vessel occlusion strokes (LVOS) after mechanical thrombectomy (MT). This inadvertent hypothermia might potentially have neuroprotective, but also adverse effects on patients' outcomes. Aim of the study is to determine the rate of hypothermia in patients with LVOS receiving MT and its influence on functional outcome. Methods: We performed a monocentric, retrospective study using a prospectively derived databank including all LVOS patients receiving MT between 2015 and 2021. Predictive value of postinterventional body temperature and body temperature categories (hyperthermia (≥38°C), normothermia (35°C-37,9°C) and hypothermia (<35°C)) on functional outcome were analyzed using multivariable Bayesian logistic regression models. Favorable outcome was defined as modified Rankin Scale (mRS) ≤3. Results: Of the 480 included LVOS-patients with MT (46.0% men, mean±SD age 73±12.9 years), 5 (1.0%) were hyperthermic, 382 (79.6%) normothermic and 93 (19.4%) hypothermic. Postinterventional hypothermia was significantly associated with unfavorable functional outcome (mRS>3) after 90 days (OR 2.06, 95%CI 1.01-4.18, p=0.045). For short-term functional outcome, patients with hypothermia had a higher discharge NIHSS (OR 1.38, 95%CI 1.06 to 1.79, p=0.015) and a higher change of NIHSS from admission to discharge (OR 1.35, 95%CI 1.03 to 1.76, p=0.029). Conclusions: About a fifth of LVOS-patients in this cohort were hypothermic after MT. Hypothermia was an independent predictor of unfavorable functional outcome. Our findings warrant a prospective trial investigating active warming during MT.

    Keywords: large vessel occlusion stroke1, mechanical thrombectomy2, hypothermia3, angio suite4, functional outcome5

    Received: 04 Feb 2024; Accepted: 08 May 2024.

    Copyright: © 2024 auf dem Brinke, Kück, Jamous, Ernst, Kunze-Szikszay, Psychogios and Maier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Kristina auf dem Brinke, Department of Neurology, University Medical Center Göttingen, Goettingen, Germany
    Ilko Maier, Department of Neurology, University Medical Center Göttingen, Goettingen, Germany

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