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Fever in patients with acute stroke has been associated with poor functional recovery and death, but does reducing fever improve outcomes? In the multicenter, double-blind Paracetamol (Acetaminophen) In Stroke (PAIS) trial, researchers in the Netherlands randomized 1400 adult patients (mean age, 70; 56% men) who had clinical diagnoses of ischemic stroke (88%) or intracerebral hemorrhage and body temperatures of 36°C to 39°C to receive either paracetamol (6 g daily for 3 days) or placebo administered orally or rectally within 12 hours of symptom onset. Concurrent treatment with paracetamol was prohibited for the first 3 days.
The primary outcome of improvement beyond expectation was determined based on the odds ratio for unfavorable outcome, …