Postoperative Fever

Abstract

Postoperative fever should alert the caregiver to the possibility of an infection complicating the recovery of the patient, but the presence of fever is not a reliable indicator of the presence of infection, and the absence of fever does not guarantee that the postoperative patient is infection-free. It is necessary to recognize that surgical infections add considerable cost to the care of patients. In a study published in 1993, postoperative infection added more than $12,000 to the cost of the patient's care; at present, this cost is certainly greater. The presence of postoperative fever in the absence of infection adds significantly to patient care--more than $9000 when compared with the uninfected patient.

Early Postoperative Fever and the “Routine” Fever Work-Up: Results of a Prospective Study

“…Postoperative fever is a relatively common event immediately after major surgical procedures, with an incidence between 10% and 40% depending on definitions [1][2][3]. Although some evidence exists for the benign and non-infectious nature of early post-operative fever [4,5], it is our experience that extensive and often reflexive ''fever work-ups'' are frequently performed to exclude infectious etiology.…”

A case of rapid progression of postoperative hyperthermia: Dantrolene or not dilemma?

“…Hyperthermia within 48 h after surgery is most likely secondary to surgical stress[1] or infectious cause. [2] Our case is interesting for the rapid progression of very high fever in PACU.…”

Fever Evaluations after Colorectal Surgery: Identification of Risk Factors that Increase Yield and Decrease Cost

“…1 In studies that have focused on patients who underwent major gastrointestinal or gynecologic operations, postoperative fever was noted in 15 to 39 percent of patients. 2,3,[5][6][7][8][9] These studies have demonstrated that the evaluation of postoperative fever with blood and urine cultures, and CXR, infrequently leads to the identification of an infectious cause of fever.…”

“…1,2 Despite an understanding that early postoperative fever most often results from the normal inflammatory response to surgery, an extensive search for an infectious etiology often is pursued. 3,4 In the evaluation of fever after major abdominal and pelvic surgery, blood cultures, urine cultures, and chest x-ray (CXR) have proven to be of little value when they are used nonselectively.…”

“…3,4 In the evaluation of fever after major abdominal and pelvic surgery, blood cultures, urine cultures, and chest x-ray (CXR) have proven to be of little value when they are used nonselectively. [1][2][3][5][6][7][8][9] Although previous studies did not exclude patients who underwent small bowel or colorectal surgery, no study has focused on the utility of fever evaluations in this patient population. This study was designed to determine the yield and cost of routine fever evaluations after major elective small bowel and colorectal surgery.…”