Risk factors associated with fever after modified electroconvulsive therapy: A session-level study.

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Medicine

Background:

• Fever is a potential adverse event following modified electroconvulsive therapy (MECT).
• Understanding the incidence and risk factors for post-MECT fever is essential for patient safety and treatment optimization.

Purpose of the Study:

• To characterize the incidence and features of fever occurring within 24 hours after MECT.
• To identify independent risk factors associated with the development of post-MECT fever.

Main Methods:

• Retrospective analysis of 3006 MECT sessions across 451 patients with psychiatric disorders.
• Fever defined as axillary temperature ≥37.3 °C within 24 hours post-session.
• Mixed-effects logistic regression used to assess associations between fever and session order, anesthetic regimen, demographics, and EEG seizure duration.

Main Results:

• Patient-level fever incidence was 20.18%; session-level incidence was 3.89%.
• Fever episodes were more frequent in the first two MECT sessions and predominantly low-grade.
• Increased risk of fever was associated with earlier treatment sessions (first and second) and longer EEG seizure duration.

Conclusions:

• Post-MECT fever is typically low-grade and more prevalent in the initial treatment phase.
• Treatment session order and EEG seizure duration are significant independent predictors of post-MECT fever.
• Balancing treatment efficacy with peri-procedural safety is critical, especially during early MECT stages.