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Postoperative fevers in pediatric solid tumor patients: how should they be managed?
Eleanor Hendershot1, Ann Chang, Kimberly Colapinto
1Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. eleanor.hendershot@sickkids.ca
Journal of Pediatric Hematology/Oncology
|July 1, 2009
Summary
Postoperative fevers in pediatric oncology patients may signal severe infection. A standardized approach including prompt assessment and antibiotics is vital to minimize complications in these high-risk patients.
Area of Science:
- Pediatric Oncology
- Surgical Infections
- Immunocompromised Patients
Background:
- Management of postoperative fevers in pediatric oncology patients after major surgery is not well-defined.
- Limited data exists on fever and infection prevalence and risk factors in this population.
Purpose of the Study:
- To determine the prevalence of fever and infection in pediatric solid tumor patients post-resection.
- To identify risk factors for postoperative infections.
- To describe current practices in fever management.
Main Methods:
- Retrospective chart review of pediatric patients with solid tumors undergoing primary tumor resection.
- Inclusion criteria: preoperative chemotherapy followed by tumor resection.
- Data collected from January 2000 to October 2005.
Main Results:
- 74% of 98 patients developed postoperative fevers; 14% had documented infections.
- Neuroblastoma diagnosis and surgeries exceeding 8 hours were associated with increased infection risk.
- Significant variation in fever investigation and management practices observed.
Conclusions:
- Postoperative fevers in this cohort can indicate severe infection.
- A standardized management approach is crucial.
- Recommendations include prompt assessment, clinical investigation, and consideration of empiric antibiotics.
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