Paracetamol could improve outcomes for stroke patients with high temperatures

The study found a 9% increase in improvement when patients with a body temperature of 37–39°C were given paracetamol.

Researchers at Erasmus MC University Medical Centre in the Netherlands studied 1400 patients with ischaemic stroke or intracerebral haemorrhage and a body temperature of 36°C-39°C.

Patients were randomly assigned to treatment with paracetamol or placebo within 12 hours of symptom onset. The improvement of the patients was assessed using the modified Rankin Scale, which measures handicap after stroke.

The research found 40% of patients with a body temperature of 37–39°C improved beyond expectation when treated with paracetamol compared with a 31% improvement in patients who received a placebo.

High body temperature in the first 12–24 hours after stroke onset is associated with poor functional outcome. Around one in three patients have a temperature greater than 37.5°C within the first hours of stroke onset.

The researchers predict one in every 11 patients with a body temperature of 37-39°C treated with paracetamol would improve beyond expectation. They conclude that a larger study is required to confirm the results.

The study will be published in the May issue of Lancet Neurology and was funded by The Netherlands Heart Foundation.

Dr Scott Kasner, of the University of Pennsylvania Medical Center said: ‘In clinical practice, existing data seem sufficient for us to comfortably conclude that paracetamol is safe and will lower high temperatures in patients with acute stroke, and that is exactly what we should use it for and what we should expect it to do.’

Lancet Neurology (2009)

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