1184. Predictive Value of Circadian Brain Temperature Rhythm in Patients with Intracerebral Hemorrhage

Authors: Wei Wei Chen, MD; Lu-Ting Kuo (Taipei, Taiwan)

Introduction: Intracerebral hemorrhage (ICH) is devastating disease with high mortality and morbidity rates. Fever is common in neurocritical care patients and is associated with poor outcome. Hypothermia has been applied in patients of brain injury; however, the rhythmic variation and its prognostic value of brain temperature in patients with ICH have never been studied. Methods: This study describes diurnal brain temperature patterns in patients who underwent surgical intervention for ICH (n=80). Temperature mesor, amplitude, and acrophase were estimated from recorded temperature measurements using cosinor analysis. The association of these patterns with clinical parameters, mortality, and 6-month functional outcome was examined. Results: Analyzed by the cosinor analysis, 55% of the patients had presence of circadian rhythm in brain temperature in the first 72 hours after surgery. The mean mesor was 37.6 (±1.21) ºC. The amplitude was diminished with a mean of 0.30 (±0.25) ºC. Shift of temperature acrophase was also observed. Analyzed by multivariate logistic regression, the final best predictive model included initial GCS and circadian rhythm of brain temperature. Conclusion: Analysis of brain temperature rhythm in patient with ICH provided additional predictive information in relation to outcome. Further research is needed to understand the pathophysiology of brain temperature regulation following ICH.