{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T19:15:56Z","timestamp":1772046956899,"version":"3.50.1"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["634809"],"award-info":[{"award-number":["634809"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Prophylactic administration of paracetamol (acetaminophen) has been reported to reduce body temperature in the first day after stroke and to reduce blood pressure on the first day. We aimed to validate these findings in the randomised PRECIOUS trial and to assess the effect of paracetamol on body temperature in the first seven days after stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>PRECIOUS was an international, 3*2 factorial, randomised, controlled, clinical trial assessing preventive treatment with paracetamol, metoclopramide, and ceftriaxone in patients aged 66 years or older with acute stroke and a score on the National Institutes of Health Stroke Scale (NIHSS) \u2265 6. Paracetamol was given in a dose of 4g daily for four days. Vital signs were recorded at 12 hours intervals up to seven days. The primary outcomes of this study were body temperature and systolic and diastolic blood pressure at 24 hours after randomisation, analysed with linear regression. The presence of a subfebrile temperature or fever at 24 hours was a secondary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We used data from 1419 of 1493 patients included in PRECIOUS. Paracetamol reduced mean body temperature by 0.1\u00b0C (95% CI, 0.0\u20130.2) at 24 hours after randomisation but did not lower systolic or diastolic blood pressure. Paracetamol reduced the occurrence of subfebrile temperatures or fever at 24 hours from 15.8% to 8.3% (p\u2009&lt;\u20090.001). The effects of paracetamol on body temperature were consistent over the four days of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prophylactic use of paracetamol resulted in a modest reduction in mean body temperature and almost halved the rate of subfebrile temperatures or fever at 24 hours after stroke, but had no effect on blood pressure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342937","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:41:01Z","timestamp":1772044861000},"page":"e0342937","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects of prophylactic use of paracetamol on body temperature and blood pressure in elderly patients with acute stroke: Data from the PRECIOUS trial"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0025-8760","authenticated-orcid":true,"given":"Jeroen C.","family":"de Jonge","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter M.","family":"Sluis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hendrik","family":"Reinink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2734-5132","authenticated-orcid":true,"given":"Philip","family":"Bath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa J","family":"Woodhouse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diederik","family":"van de Beek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-2760","authenticated-orcid":true,"given":"Anne Hege","family":"Aamodt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Ciccone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janika","family":"K\u00f5rv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwona","family":"Kurkowska-Jastrzebska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milani","family":"Deb-Chatterji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Ntaios","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6tz","family":"Thomalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H Bart","family":"van der Worp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the PRECIOUS investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"12","key":"pone.0342937.ref001","doi-asserted-by":"crossref","first-page":"3357","DOI":"10.1161\/STROKEAHA.111.621425","article-title":"Epidemiology and outcomes of fever burden among patients with acute ischemic stroke","volume":"42","author":"MS Phipps","year":"2011","journal-title":"Stroke"},{"issue":"9","key":"pone.0342937.ref002","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1161\/STROKEAHA.109.556134","article-title":"Effect of hyperthermia on prognosis after acute ischemic stroke","volume":"40","author":"VISTA 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Rationale and design of a randomised, open, phase III, clinical trial with blinded outcome assessment","volume":"3","author":"H Reinink","year":"2018","journal-title":"Eur Stroke J"},{"issue":"1","key":"pone.0342937.ref018","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-020-04717-0","article-title":"PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke-statistical analysis plan of a randomised, open, phase III, clinical trial with blinded outcome assessment","volume":"21","author":"JC de Jonge","year":"2020","journal-title":"Trials"},{"issue":"11","key":"pone.0342937.ref019","doi-asserted-by":"crossref","first-page":"3029","DOI":"10.1161\/STROKEAHA.108.521583","article-title":"Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis","volume":"39","author":"DM Greer","year":"2008","journal-title":"Stroke"},{"issue":"8999","key":"pone.0342937.ref020","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0140-6736(96)90008-2","article-title":"Body temperature in acute stroke: relation to stroke severity, infarct size, mortality, and outcome","volume":"347","author":"J Reith","year":"1996","journal-title":"Lancet"},{"issue":"1","key":"pone.0342937.ref021","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.001307","article-title":"Can a novel clinical risk score improve pneumonia prediction in acute stroke care? 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