Hospital Clínico Universidad de Chile

The 2024 WHO guidelines for chronic hepatitis B ( CHB ) aim to expand and simplify treatment eligibility. We aimed to estimate treatment eligibility and uptake according to country‐specific guidelines and evaluate treatment expansion based on the WHO guidelines. Treatment‐naïve CHB patients from Argentina, Brazil, Chile and Uruguay referred to evaluation between January 2010 and June 2024 were retrospectively included. Treatment candidacy was evaluated according to both country‐specific and WHO guidelines. A total of 719 patients with CHB , treatment naïve, were included (67.1% male; median age: 50.4 years; HBeAg ‐positive: 36.3%). The median HBV ‐ DNA level was 43,000 ( IQR 633–110,000,000) IU /mL, median ALT was 41 ( IQR 23–99) U/L, 47.0% had an APRI > 0.5 and 21.1% had cirrhosis. According to country‐specific guidelines, 56.9% (95% CI : 53.2–60.5) met the criteria for treatment. Antiviral treatment was initiated in 84.3% of eligible patients. The proportion of patients meeting treatment criteria under the WHO guidelines increased to 67.3% (95% CI : 63.8–70.6), resulting in a 10.4% (95% CI : 8.1–12.8) increase in treatment candidacy. Treatment expansion was significantly higher in women (15.2%; 95% CI : 10.2–20.1) than in men (8.1%; 95% CI : 5.4–10.7). According to WHO guidelines, a considerable proportion of CHB patients who do not meet country‐specific criteria are eligible for antiviral therapy. Implementing WHO criteria can enhance treatment rates and advance efforts toward CHB elimination.

In the INTRIGUE phase III trial (ClinicalTrials.gov identifier: NCT03673501 ), adult patients with advanced gastrointestinal stromal tumor previously treated with imatinib were randomly assigned 1:1 to ripretinib 150 mg once daily or sunitinib 50 mg once daily (4 weeks on/2 weeks off). In the primary analysis, overall survival (OS) was immature. In this study, we report the final planned analysis of OS (key secondary end point), progression-free survival (PFS) on third-line therapy (second PFS; prespecified exploratory end point), and long-term safety. Final OS analysis was prespecified to occur with approximately 200 and ≥145 events in the overall and KIT exon 11 intention-to-treat (ITT) populations, respectively. As of March 15, 2023, there were 211 and 151 OS events in the overall ITT and KIT exon 11 ITT populations, respectively. Median OS was similar between second-line ripretinib and sunitinib in both populations (overall, 35.5 v 31.5 months; KIT exon 11, 35.5 v 32.8 months). Median second PFS (on third-line therapy) for the overall ITT population was similar between the ripretinib and sunitinib arms (7.7 v 7.4 months). Safety was consistent with the primary analysis. OS from this analysis was similar between arms, and second PFS suggests that receiving ripretinib did not adversely affect the PFS of third-line therapy.

Aims: Latin America has been underrepresented in trials evaluating immunotherapy for hepatocellular carcinoma (HCC). We aimed to describe the incidence of immune-related adverse events (irAEs) and their impact on outcomes in a Latin American cohort. Methods: A multicenter prospective study was conducted in Argentina, Brazil, Chile, and Colombia, including patients who received atezolizumab plus bevacizumab. A time-covarite proportional hazard analysis evaluated the effect of irAEs. Results: 99 patients were included. The median treatment duration was 6 months, with a median survival of 17.0 months (95% CI: 12.6-19.8). The irAE incidence rate was 2.1 cases per 100 persons-months (cumulative incidence 18.1% (95% CI: 11.1-27.2%)). Median time to irAE was 2.3 months (range 1.4-4.8), most frequently hepatitis (n = 6), thyroiditis (n = 5), and 8/18 required steroids. Follow-up, treatment duration, and overall survival were similar regardless of the occurrence of irAEs (HR = 1.71, 95% CI: 0.76-3.86; P = 0.19). Baseline alpha-feto protein ≥400 ng/ml (HR: 2.9 (95% CI: 1.1-7.6)) was independently associated with irAE. Conclusion: The incidence of irAEs in this cohort is lower than reported in controlled trials, withouut impact on survival outcomes. Education and early recognition are crucial to ensure that these events are identified and addressed.

Introduction Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve functional dysfunction of the construction of inner cognitive maps, leading to disrupted spatial cognition processes as a core feature. The present studies attempt to unravel the neural mechanisms that underlie spatial navigation in PPPD. Methods Fifty-two participants completed the study: 19 PPPD patients, 20 control subjects with vestibular disorders but without PPPD (with comparable peripheral vestibular function to the PPPD group, and 13 healthy volunteers). All underwent a virtual Morris Water Maze (vMWM) task in both, non-immersive (NI) and virtual reality (VR) modalities, assessing spatial navigation performance, gaze behavior, and head kinematics. Results PPPD patients exhibited significantly worse navigation performance than both control groups across all metrics, with greater impairments in predominantly allocentric tasks. They also showed increased exploratory gaze behavior, unaffected by NI vs. VR modality or task condition. Head kinematics did not significantly differ between the three groups, though a non-significant trend indicated reduced head movement in both PPPD and vestibular controls. VR intolerance was highest in PPPD patients, followed by vestibular controls, with healthy volunteers showing the lowest discomfort. Discussion Our findings suggest that PPPD involves deficits in allocentric spatial navigation, likely due to predictive coding errors and impaired internal model updating, rather than sensory input dysfunction. Increased gaze scanning may reflect compensatory mechanisms for spatial uncertainty. Notably, VR immersion did not alter navigation performance, suggesting visuo-vestibular conflict is not the primary driver of PPPD-related spatial deficits. These findings offer new insights into PPPD as a disorder of spatial cognition, opening avenues for novel diagnostic and therapeutic approaches.

Background During the last decades, intensive care unit (ICU) mortality rates have significantly decreased but this progress has come with unintended consequences for patients and their caregivers. The adverse health-related effects observed in caregivers during the post-ICU period are referred to as Post-Intensive Care Syndrome-Family (PICS-F). Despite growing awareness of PICS-F, the long-term challenges faced by caregivers of ICU patients are not well characterized with several gaps in knowledge remaining unaddressed. The proposed study aims to determine the incidence of PICS-F impairments and identify associated factors among caregivers of ICU survivors. Methods We plan to conduct a longitudinal prospective cohort study involving 175 caregivers of ICU patients admitted to a public hospital in Chile. Data will be collected during ICU admission, after ICU discharge, 3 months and 6 months after hospital discharge. Questionnaires will evaluate caregivers’ psychological, physical and cognitive outcomes and perceived social support, resilience, family satisfaction and caregiver burden. Factors associated with PICS-F impairments will be explored using generalised linear mixed models. Discussion The current understanding of PICS-F is limited, particularly regarding the risk and protective factors associated with the syndrome among caregivers of ICU survivors. This study will contribute to addressing this gap by providing novel data about PICS-F and exploring previously unexamined factors linked to PICS-F such as family satisfaction, psychological buffers and caregiver burden. Trial Registration Clinicaltrials.gov: NCT05827354. Registered on 25 April 2023.

Background During the COVID-19 pandemic, many physicians experienced burnout, underscoring the need to identify factors associated with this condition to develop effective prevention and treatment strategies. Objective To examine the relationship between physician burnout and individual factors, medical errors, medical leave and the work environment. Design A cross-sectional online survey conducted from November 2020 to December 2020. Participants Physicians registered with the Medical College of Chile. Setting Registered physicians working in Chile across primary, secondary and tertiary levels of healthcare. Primary outcomes Burnout was assessed using the Maslach Burnout Inventory for Human Services. Secondary outcomes Self-reported medical errors, medical leave and turnover. Independent variables Sociodemographic characteristics, personality factors, psychological well-being, mindfulness factors, self-compassion and work environment factors. Descriptive statistics, linear and logistic regressions and regression analyses with cross-validation using least absolute shrinkage and selection operator (LASSO) tests were applied. Results Of the 23 481 registered physicians, 795 (3.4%) completed the survey. The sample included 64.1% women, with a mean age of 37.7 years (SD=11.3). The prevalence of burnout syndrome was 20.4% based on strict criteria and 68.9% based on lax criteria. Burnout scores predicted days of medical leave (ß=0.086, p<0.01), turnover (ß=0.012, p<0.05) and perceived medical errors (ß=0.009, p<0.001). In contrast, burnout was inversely correlated with age (ß=−0.125, p<0.001), agreeableness as a personality trait (ß=−0.107, p<0.001), psychological well-being (ß=−0.248, p<0.001) and the mindfulness factor awareness (ß=−0.145, p<0.001). In the work environment, time pressure (ß=0.167, p<0.001) was positively associated with burnout among others. Conclusion Younger physicians may be prioritised for individual-level interventions, while addressing time pressure at the organisational level could help prevent burnout. However, longitudinal studies are needed to clarify the directionality of relationships with psychological factors. Trial registration number NCT05013489; Results.

Objective This study aimed to assess whether surgical times in robotic-assisted total knee arthroplasty (rTKA) could be comparable to those of conventional total knee arthroplasty (TKA), and to identify the point in the learning curve at which this occurs. Methods A time-series analysis was conducted on the first 50 consecutive primary rTKA procedures performed by a single surgeon at a university hospital. The surgeon, with seven years of experience and performing 30 TKA surgeries annually, used the ROSA® (Zimmer Biomet, Warsaw, IN, USA) robotic system for all procedures. Surgical times were analyzed using a Markov switching model to detect significant changes in operative duration. A Kruskal-Wallis test was applied to compare surgical times between rTKA and conventional TKA groups, with post hoc analysis conducted to assess differences between the first and second epochs of rTKA and conventional TKA. Results Markov analysis revealed two distinct epochs in surgical performance, with a significant reduction in surgical time occurring after the 20th case. The median surgical time in the first epoch was 118 minutes, compared to 105 minutes in the second epoch. The conventional TKA group had a median surgical time of 100 minutes. Statistical analysis, using the Kruskal-Wallis test, identified significant differences among the groups, with post hoc testing revealing no significant difference between the second epoch of rTKA and conventional TKA. Conclusions Surgical times for rTKA become comparable to those of conventional surgery after approximately 20 cases. These findings suggest that rTKA does not negatively impact operating room efficiency once the surgeon gains proficiency with the technology.

Objective Antidepressants remain among the most widely used class of drugs in treating bipolar disorder, despite their minimal efficacy in randomized clinical trials and concern for association with manic episodes. This study sought to evaluate the outcomes of antidepressant treatment in bipolar depression in a large naturalistic cohort study, STEP‐BD, in terms of symptomatic remission as well as emergence of mania, using a propensity score (PS) analysis to reduce indication bias. Methods Propensity scores were developed to estimate the probability of antidepressant exposure using multivariate logistic regression models; these scores were then used to match antidepressant‐exposed and non‐exposed individuals. Cox regression models were used to estimate hazard ratios for manic switch and time to remission, adjusted for these scores in the matched population. Results Total sample included 2166 individuals, of whom 1085 were exposed to AD and 1081 were unexposed to AD; mean follow‐up duration was 182.5 (SD: 44.6) days (median = 126, ICR: 87.4). Cox regression models for manic switch with antidepressant exposure versus non‐exposure yielded an unadjusted hazard ratio (HR) of 0.93 (95% CI 0.67–1.14) and PS‐adjusted HR of 0.77 (95% CI 0.51–1.08), neither of which was statistically significantly different from 1. Probability of symptomatic remission was also not significantly associated with antidepressant exposure, with unadjusted and PS‐adjusted HR of 1.15 (95% CI 0.97–1.37) and 1.02 (95% CI 0.87–1.23), respectively. Conclusion With PS adjustment, there was no evidence of increased likelihood of manic switch or achievement of symptomatic remission associated with antidepressant use in bipolar depression. Our results underscore the ongoing need to identify alternative strategies for effective treatment of bipolar depression.

Uveitis, a group of heterogeneous diseases causing ocular inflammation, is a major contributor to vision loss globally. While systemic corticosteroids (CS) are the mainstay treatment, identifying CS-refractory patients remains a significant challenge. This study aimed to explore cytokine expression and Glucocorticoid Receptor (GR) levels as biomarkers for the early detection of CS-refractory cases in non-infectious uveitis. We assayed blood samples from 19 patients with non-infectious uveitis, for the expression of IL-6, IL-17A, TNF-α, IL-10 and GRα. The cohort included 11 refractory and 8 sensitive patients, categorized based on their clinical response to corticosteroids (prednisone 1 mg/kg/day). Blood draws were conducted at three time points (at baseline, day 7- and day 14 after CS initiation), and peripheral blood mononuclear cells (PBMCs) were isolated to measure cytokine and GRα transcript levels via real-time PCR. The expression levels of GRα and cytokines IL-6, IL-17A and TNF-α did not show significant changes between CS-sensitive and CS-refractory patients on the different days of treatment. However, IL-10 expression levels as the day14-to-day7 ratio were significantly higher in patients sensitive to CS therapy. A higher day14-to-day7 ratio was also found for the IL-6/IL-10, IL-17A/IL-10 and GRα/IL-10 ratios. ROC curve analysis demonstrated a robust predictive performance of IL-10 mRNA expression and the IL-6/IL-10 ratio for identifying CS-refractory patients. In conclusion, the expression of IL-10 and the IL-6/IL-10 ratio hold promise as early predictive biomarkers for CS treatment refractoriness in patients with non-infectious uveitis. These findings offer valuable insights into personalized treatment strategies, potentially leading to improved clinical outcomes.

Introduction Rheumatoid arthritis (RA) is an autoimmune disease influenced by genetic factors, particularly HLA-DRB1 alleles. The objective of this study was to characterize the distribution of HLA-DRB1 alleles in Chilean RA patients and healthy controls (HC) and evaluate associations with susceptibility or protection, autoantibody seropositivity, and disease activity. Methods We genotyped 367 RA patients and 623 HC for HLA-DRB1 using PCR-SSO. Then, we examined allele frequencies and distribution, including known RA risk alleles of the “Shared Epitope” (SE) of HLA-DRB1 and protective (PR) alleles, using the Chi-square or Fisher’s exact tests. Odds ratios with 95% confidence intervals were calculated to measure the degree of association, and unpaired T-tests were used to compare continuous variables. Results The most frequent SE alleles among RA patients were *04:01 (16.1%), *04:04 (13.9%), and *14:02 (11.7%). SE alleles *04:01, *04:04, *04:05, *04:08, and *10:01, along with non-SE alleles *09:01 and *15:02, were associated with RA susceptibility. In addition, allele *14:02 showed an association with the presence of anti-cyclic citrullinated peptides (anti-CCP) antibodies. Meanwhile, PR alleles *11:01 (14.8%) and *16:02 (9.8%) were observed most frequently in HC and RA patients, respectively. PR alleles *11:01, *11:04, and *13:01, as well as the non-PR alleles *15:01, *04:07, *03:01, *07:01, and *08:02, were associated with protection from RA, and showed no significant associations with autoantibody seropositivity. Discussion This study provides a comprehensive overview of HLA-DRB1 allele distribution in the Chilean population, identifying both well-known and novel allele associations with RA susceptibility, protection, and disease activity.

BACKGROUND Infection by the hepatitis B virus (HBV) represents a significant global socio-sanitary burden. While liver transplantation (LT) is an important therapeutic option, treatments that prevent HBV reinfection are necessary. The combination of anti-hepatitis B immunoglobulin (HBIG) and nucleoside/nucleotide analogs (NA) is the standard post-transplant treatment; however, there are limitations in using HBIG, particularly its cost. We present two illustrative clinical cases as examples of post-transplant management using dual NA therapy, unaccompanied by HBIG. CASE SUMMARY The first case involves a 42-year-old man with HBV-related cirrhosis, who, in the context of a diagnosis of hepatocellular carcinoma and hepatopulmonary syndrome, underwent LT without viremia at the time of transplantation. A lack of availability of HBIG led to the combined use of two NAs, entecavir, and tenofovir alafenamide—resulting in the negativization of hepatitis B surface antigen (HBsAg) and maintenance of a negative viral load in the post-transplant period. In the second case, a 63-year-old woman presented with acute hepatic failure due to HBV with viremia during transplantation. Combined therapy with entecavir and tenofovir alafenamide, again due to the unavailability of HBIG, ultimately led to the negativization of HBsAg and viral load. CONCLUSION These cases suggest the efficacy of dual NA therapy in post-transplant HBV management, emphasizing the need to reconsider traditional treatment approaches.

Macrophages are pivotal in osteoarthritis (OA) pathogenesis, as their dysregulated polarization can contribute to chronic inflammatory processes. This review explores the molecular and metabolic mechanisms that influence macrophage polarization and identifies potential strategies for OA treatment. Currently, non-surgical treatments for OA focus only on symptom management, and their efficacy is limited; thus, mesenchymal stem/stromal cells (MSCs) have gained attention for their anti-inflammatory and immunomodulatory capabilities. Emerging evidence suggests that small extracellular vesicles (sEVs) derived from MSCs can modulate macrophage function, thus offering potential therapeutic benefits in OA. Additionally, the transfer of mitochondria from MSCs to macrophages has shown promise in enhancing mitochondrial functionality and steering macrophages toward an anti-inflammatory M2-like phenotype. While further research is needed to confirm these findings, MSC-based strategies, including the use of sEVs and mitochondrial transfer, hold great promise for the treatment of OA and other chronic inflammatory diseases.

Background Neuromuscular diseases (NMDs) are rare disorders characterized by progressive muscle fibre loss, leading to replacement by fibrotic and fatty tissue, muscle weakness and disability. Early diagnosis is critical for therapeutic decisions, care planning and genetic counselling. Muscle magnetic resonance imaging (MRI) has emerged as a valuable diagnostic tool by identifying characteristic patterns of muscle involvement. However, the increasing complexity of these patterns complicates their interpretation, limiting their clinical utility. Additionally, multi‐study data aggregation introduces heterogeneity challenges. This study presents a novel multi‐study harmonization pipeline for muscle MRI and an AI‐driven diagnostic tool to assist clinicians in identifying disease‐specific muscle involvement patterns. Methods We developed a preprocessing pipeline to standardize MRI fat content across datasets, minimizing source bias. An ensemble of XGBoost models was trained to classify patients based on intramuscular fat replacement, age at MRI and sex. The SHapley Additive exPlanations (SHAP) framework was adapted to analyse model predictions and identify disease‐specific muscle involvement patterns. To address class imbalance, training and evaluation were conducted using class‐balanced metrics. The model's performance was compared against four expert clinicians using 14 previously unseen MRI scans. Results Using our harmonization approach, we curated a dataset of 2961 MRI samples from genetically confirmed cases of 20 paediatric and adult NMDs. The model achieved a balanced accuracy of 64.8% ± 3.4%, with a weighted top‐3 accuracy of 84.7% ± 1.8% and top‐5 accuracy of 90.2% ± 2.4%. It also identified key features relevant for differential diagnosis, aiding clinical decision‐making. Compared to four expert clinicians, the model obtained the highest top‐3 accuracy (75.0% ± 4.8%). The diagnostic tool has been implemented as a free web platform, providing global access to the medical community. Conclusions The application of AI in muscle MRI for NMD diagnosis remains underexplored due to data scarcity. This study introduces a framework for dataset harmonization, enabling advanced computational techniques. Our findings demonstrate the potential of AI‐based approaches to enhance differential diagnosis by identifying disease‐specific muscle involvement patterns. The developed tool surpasses expert performance in diagnostic ranking and is accessible to clinicians worldwide via the Myo‐Guide online platform.

Background Overweight and obesity in children are rising globally, and the Mediterranean diet may help reduce obesity and related diseases. Objective To assess the association between adherence to the Mediterranean diet and body composition in Spanish preschool children. Methods This study included 1218 children aged 3–6 years from the CORALS cohort. Mediterranean diet adherence was evaluated using the validated MED4CHILD and COME‐Kids F&B‐FQ questionnaires. Body composition measurements included weight, height, waist circumference, BMI, Fat Mass (FM), Fat‐Free Mass Index (FFMI), and Waist‐to‐Height ratio (WtHR). Multivariate regression and ANCOVA were used to examine associations, adjusting for factors like age, physical activity, and energy intake. We also performed a Cohen's d analysis to assess effect size. Results Adherence to the Mediterranean diet was associated with more favourable body composition in children. Specifically, both the MED4CHILD score and the COME‐Kids‐derived score showed significant associations with BMI, FFMI, and Waist‐to‐Height ratio, showing differences by sex. Children who adhered to the Mediterranean diet exhibited lower BMI and higher fat‐free mass, and a more favourable waist‐to‐height ratio. Additionally, although some measures showed weaker associations, all analyses highlighted a trend towards improved body composition with higher adherence. Cohen's d analysis showed small to moderate effect sizes. Conclusion Adherence to the Mediterranean diet was significantly linked to favorable body composition indices in Spanish children, highlighting the importance of promoting healthy dietary patterns to prevent overweight and obesity.

Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune astrocytopathy mediated by aquaporin-4-immunoglobulin G (AQP4-IgG) antibodies, leading to complement-mediated neural injury. While ravulizumab, a long-acting C5 inhibitor, is approved for relapse prevention in AQP4-IgG-positive NMOSD, its role in acute attacks remains unestablished. We report a 58-year-old woman with a highly relapsing course of AQP4-IgG-positive NMOSD who developed a fulminant attack with bilateral corticospinal tract involvement, resulting in asymmetrical tetraparesis. Despite high-dose intravenous methylprednisolone and plasma exchange (PLEX), neurological deterioration progressed. Ravulizumab (2,700 mg) was administered emergently following meningococcal prophylaxis. After treatment, neurological decline ceased, allowing gradual motor recovery and rehabilitation. At discharge, the patient showed improved strength and functional capacity, although significant disability persisted. This case suggests that ravulizumab may provide clinical stabilization in refractory NMOSD attacks unresponsive to conventional therapy. The temporal association between ravulizumab administration and the halt in clinical progression suggests a possible therapeutic effect; however, delayed responses to steroids and PLEX, along with the confounding use of intravenous Ig, preclude definitive attribution. While the use of complement inhibitors has been well established in relapse prevention, evidence for their use in acute NMOSD exacerbations remains limited. This report highlights the need for controlled studies to evaluate the efficacy, safety, and timing of ravulizumab in the management of acute, treatment-resistant NMOSD relapses.

Background and Aims The survival outcomes associated with hepatic recompensation in patients with advanced hepatocellular carcinoma (HCC) treated with first‐line systemic therapies remain unclear. We compared survival from the initiation of first‐line systemic treatments for advanced HCC among patients with compensated, decompensated, and recompensated cirrhosis. Methods A Latin American multicenter, prospective cohort study was conducted from 2018 to 2024, involving patients with HCC and Child‐Pugh class A or B who received systemic therapy. At the time of first‐line therapy, patients with cirrhosis were categorised as compensated (never decompensated), decompensated, or recompensated. Cox proportional hazards models were estimated. Results Among 306 patients receiving first‐line systemic therapy (sorafenib: 60.5%, atezolizumab + bevacizumab: 29.7%, lenvatinib: 9.1%), 240 had cirrhosis, with 30.4% having a history of hepatic decompensation. Of these, 57.5% (95% CI 45.4%–69.0%) achieved hepatic recompensation over a median period of 12 months. At the time of first‐line therapy, 69.6% were compensated, 17.5% recompensated, and 12.9% decompensated. Metabolic‐associated steatotic liver disease (MASLD) was the most common underlying aetiology in the recompensated group. Median survival was significantly shorter in the decompensated group (8.6 months) compared to the compensated group (17.2 months) [aHR 1.91 (95% CI 1.04–3.5); p = 0.03], without a significant difference between the recompensated and compensated groups [aHR 1.28 (95% CI 0.79–2.1); p = 0.31]. Tumour progression was the primary reason for treatment discontinuation, and similar access to second‐line therapies was observed between the compensated and recompensated groups. Conclusion Patients with cirrhosis and advanced HCC who achieved hepatic recompensation might benefit from systemic therapies after a cautious observation period.

Hyperthermia within the first 24 h following ischemic stroke (IS) has been associated with poor outcomes. We sought to determine whether blood–brain barrier (BBB) permeability contributes to the relationship between hyperthermia and early infarct growth (EIG). A retrospective analysis was conducted on a prospective stroke biobank. EIG was defined as the percentage difference between the initial volume (mL) determined by the diffusion-weighted imaging at admission and the volume (mL) from the control CT image on the 4 th–7 th day. Hyperthermia was defined as an axillary body temperature ≥ 37.5 °C within the first 24 h. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) serum levels were measured by ELISA. One-hundred and two (19.7%) patients showed EIG from a cohort of 519 patients (45.6% females). Linear correlation was observed for axillar body temperature and EIG (Pearson’s r = 0.46; p < 0.001). sTWEAK serum levels showed a c-statistic of 0.74 (95% CI: 0.69–0.79), with an optimal cut-off point > 3000 pg/mL for EIG prediction. Moreover, microalbuminuria levels strongly correlated with sTWEAK levels (Pearson’s r = 0.75; p < 0.001). In the multivariate analysis for EIG was observed an independent association with hyperthermia (adjusted OR 24.21; 95% CI: 12.03–39.12), sTWEAK levels > 3000 pg/mL (adjusted OR 16.43; 95% CI: 3.71–72.70), leukoaraiosis (adjusted OR 10.42; 95% CI: 2.68–39.08), and microalbuminuria (adjusted OR 1.02; 95% CI: 1.00–1.12). In our cohort, hyperthermia was independently associated with EIG after IS. The fact that microalbuminuria, leukoaraiosis, and sTWEAK were also associated with EIG suggests a relationship with increased BBB permeability.