Abstract
Objective: To assess the incidence and associations of paroxysmal sympathetic hyperactivity (PSH) among febrile patients in the neurological intensive care unit (NICU). Methods: Prospective data collection of consecutive patients admitted to an academic NICU for > 48 hours. Fever was defined as body temperature> 38.3°C (101.0° F) on at least one measurement for two consecutive days. PSH was defined by the transient presence of four of the following six criteria: fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and extensor posturing or severe dystonia in the absence of other potential causes for these clinical signs. Methods: Ninety-three patients were included. Traumatic brain injury (TBI) was the primary diagnosis in 43 patients (46%). PSH were diagnosed in 17 patients (18%). It occurred in 14/43 patients (33%) with TBI but only 3/50 patients (6%) with other primary disorders (p=0.01). Patients with PSH were younger (mean age: 35 ± 14 versus 51 ± 18 years old in the rest of the population) (p=0.01), although the difference did not reach statistical significance when only TBI patients were included in the analysis (mean age: 35 ± 15 years old in TBI patients with PSH versus 46 ± 19 years old in TBI patients without PSH; p=0.07). Duration of fever in patients with PSH (mean: 10.5 ± 7 days; median: 9 days) was significantly longer than in the rest of the population (mean: 5.7 ± 3 days) (p<0.001); the difference remained significant when the analysis was restricted to TBI patients (p=0.001). Conclusion: Episodes of PSH occur in one-third of TBI patients but are rare in other acute neurological conditions. They are more frequent in younger patients and are associated with prolonged duration of fever.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 680-682 |
| Number of pages | 3 |
| Journal | Neurological Research |
| Volume | 29 |
| Issue number | 7 |
| DOIs | |
| State | Published - Oct 1 2007 |
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Keywords
- Causes
- Fever
- Neurological-neurosurgical ICU
- Predictors
- Sympathetic hyperactivity
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Paroxysmal sympathetic hyperactivity in the neurological intensive care unit. / Rabinstein, Alejandro.
In: Neurological Research, Vol. 29, No. 7, 01.10.2007, p. 680-682.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Paroxysmal sympathetic hyperactivity in the neurological intensive care unit
AU - Rabinstein, Alejandro
PY - 2007/10/1
Y1 - 2007/10/1
N2 - Objective: To assess the incidence and associations of paroxysmal sympathetic hyperactivity (PSH) among febrile patients in the neurological intensive care unit (NICU). Methods: Prospective data collection of consecutive patients admitted to an academic NICU for > 48 hours. Fever was defined as body temperature> 38.3°C (101.0° F) on at least one measurement for two consecutive days. PSH was defined by the transient presence of four of the following six criteria: fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and extensor posturing or severe dystonia in the absence of other potential causes for these clinical signs. Methods: Ninety-three patients were included. Traumatic brain injury (TBI) was the primary diagnosis in 43 patients (46%). PSH were diagnosed in 17 patients (18%). It occurred in 14/43 patients (33%) with TBI but only 3/50 patients (6%) with other primary disorders (p=0.01). Patients with PSH were younger (mean age: 35 ± 14 versus 51 ± 18 years old in the rest of the population) (p=0.01), although the difference did not reach statistical significance when only TBI patients were included in the analysis (mean age: 35 ± 15 years old in TBI patients with PSH versus 46 ± 19 years old in TBI patients without PSH; p=0.07). Duration of fever in patients with PSH (mean: 10.5 ± 7 days; median: 9 days) was significantly longer than in the rest of the population (mean: 5.7 ± 3 days) (p<0.001); the difference remained significant when the analysis was restricted to TBI patients (p=0.001). Conclusion: Episodes of PSH occur in one-third of TBI patients but are rare in other acute neurological conditions. They are more frequent in younger patients and are associated with prolonged duration of fever.
AB - Objective: To assess the incidence and associations of paroxysmal sympathetic hyperactivity (PSH) among febrile patients in the neurological intensive care unit (NICU). Methods: Prospective data collection of consecutive patients admitted to an academic NICU for > 48 hours. Fever was defined as body temperature> 38.3°C (101.0° F) on at least one measurement for two consecutive days. PSH was defined by the transient presence of four of the following six criteria: fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and extensor posturing or severe dystonia in the absence of other potential causes for these clinical signs. Methods: Ninety-three patients were included. Traumatic brain injury (TBI) was the primary diagnosis in 43 patients (46%). PSH were diagnosed in 17 patients (18%). It occurred in 14/43 patients (33%) with TBI but only 3/50 patients (6%) with other primary disorders (p=0.01). Patients with PSH were younger (mean age: 35 ± 14 versus 51 ± 18 years old in the rest of the population) (p=0.01), although the difference did not reach statistical significance when only TBI patients were included in the analysis (mean age: 35 ± 15 years old in TBI patients with PSH versus 46 ± 19 years old in TBI patients without PSH; p=0.07). Duration of fever in patients with PSH (mean: 10.5 ± 7 days; median: 9 days) was significantly longer than in the rest of the population (mean: 5.7 ± 3 days) (p<0.001); the difference remained significant when the analysis was restricted to TBI patients (p=0.001). Conclusion: Episodes of PSH occur in one-third of TBI patients but are rare in other acute neurological conditions. They are more frequent in younger patients and are associated with prolonged duration of fever.
KW - Causes
KW - Fever
KW - Neurological-neurosurgical ICU
KW - Predictors
KW - Sympathetic hyperactivity
UR - http://www.scopus.com/inward/record.url?scp=36048955164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=36048955164&partnerID=8YFLogxK
U2 - 10.1179/016164107X240071
DO - 10.1179/016164107X240071
M3 - Article
C2 - 18173907
AN - SCOPUS:36048955164
VL - 29
SP - 680
EP - 682
JO - Neurological Research
JF - Neurological Research
SN - 0161-6412
IS - 7
ER -