To investigate the application effect of a stepped targeted temperature management strategy in patients with severe subarachnoid hemorrhage (SAH).

Clinical data of 80 patients with severe SAH admitted to Shuyang Hospital Affiliated to Xuzhou Medical University from September 2021 to October 2024 were retrospectively analyzed, including 51 males and 29 females, aged 51~75 years, with a mean age of (65.03±5.31) years. Thirty-eight patients who received conventional temperature management from September 2021 to March 2023 were assigned to the control group, and 42 patients who received the targeted temperature management strategy (target temperature 36 ℃) from April 2023 to October 2024 were assigned to the observation group. Interventions in both patient groups were performed until discharge. Body temperature data were collected before intervention and at 12, 24, and 48 hours after intervention. National Institutes of Health Stroke Scale (NIHSS) scores were recorded before intervention, at 48 hours after intervention, and at discharge. Hunt-Hess grades before intervention and at discharge, as well as the incidence of complications in both patient groups, were also collected.

Repeated-measures analysis of variance showed significant intergroup and temporal effects on body temperature between the two patient groups (P<0.05), with a significant interaction between time points and groups (P<0.05). Simple effect analysis with Bonferroni correction revealed that body temperature in the observation group was lower than that in the control group at 12, 24, and 48 hours after intervention (P<0.05), and the achievement rate of the target temperature (36 ℃) at 48 hours in the observation group was higher than that in the control group (P<0.05). Repeated-measures analysis of variance also showed significant intergroup and temporal effects on NIHSS scores between the two patient groups (P<0.05), with a significant interaction between time points and groups (P<0.05). Simple effect analysis with Bonferroni correction indicated that NIHSS scores in the observation group were lower than those in the control group at 48 hours after intervention and at discharge (P<0.05). At discharge, the Hunt-Hess grade in the observation group was superior to that in the control group (P<0.05), and the total incidence of complications in the observation group was lower than that in the control group (P<0.05).

The stepped targeted temperature management strategy (target temperature 36 ℃) is conducive to controlling body temperature, reducing the incidence of complications in patients with severe SAH, and possesses favorable clinical application value.