Yield of postoperative fever evaluation

Introduction: In women undergoing major gynecologic surgeries, we wish to determine the frequency and yield of blood cultures, urine cultures, and chest x-ray as part of postoperative fever evaluation.Methods: A retrospective review of 537 consecutive patients undergoing major gynecologic surgery. Postoperative fever was any temperature >/=38 degrees C. In patients who developed postoperative fever, it was determined if blood cultures, urine cultures, and chest x-rays were performed and how frequently these yielded positive results.Results: Two hundred eleven patients (39%) developed postoperative fever. Blood cultures were obtained in 77 of 211 (37%) febrile patients, urine cultures in 106 of 211 (50%) febrile patients, and chest x-rays in 54 of 211 (26%) febrile patients. Zero of 77 blood cultures were positive, 11 of 106 (10%) urine culture were positive, and 5 of 54 (9%) chest x-rays were positive. Logistic regression revealed that late onset fever predicted for positive urine cultures and early onset fever and advanced age predicted for pneumonia. Eighty percent of patients with pneumonia were symptomatic.Conclusion: Although postoperative fevers are routinely evaluated by blood cultures, urine cultures, and chest x-rays, they rarely yield positive results.