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Updated: Apr 14, 2026

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Postoperative Fever in Children Hospitalized After Surgery: Incidence and Risk Factors.

Peter J Hong1,2,3, Lynne Ferrari3,4, Steven Staffa4

  • 1Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.

Hospital Pediatrics
|April 12, 2026
PubMed
Summary

Postoperative fever (PoF) affects 1 in 5 pediatric surgical patients, with rates varying by procedure. Longer surgeries, younger age, lower weight, and more chronic conditions increase PoF risk.

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Area of Science:

  • Pediatric Surgery
  • Clinical Outcomes
  • Infectious Disease Epidemiology

Background:

  • Pediatricians increasingly manage care for children undergoing surgery.
  • Understanding the natural history of postoperative fever (PoF) is crucial for optimizing patient care.
  • This study investigates PoF incidence and risk factors in hospitalized pediatric surgical patients.

Purpose of the Study:

  • To assess the incidence of postoperative fever (PoF) stratified by surgical procedure type.
  • To identify patient- and procedure-level risk factors associated with PoF in pediatric surgical patients.
  • To provide data for improved clinical management and risk stratification.

Main Methods:

  • Retrospective analysis of 35,030 inpatient surgical admissions from 2016-2023.
  • PoF defined as temperature ≥38.0°C within 7 days post-surgery.
  • Mixed-effects logistic regression used to evaluate risk factors including operative duration, age, weight Z score, and chronic conditions.

Main Results:

  • The overall incidence of PoF was 20.3%.
  • PoF rates varied significantly by surgical domain, from 8.1% (ophthalmologic) to 35.2% (cardiovascular).
  • Key risk factors identified: operative duration (≥6 hours), younger age (1-4 years), lower weight Z score (< -2), and number of chronic conditions (≥9).

Conclusions:

  • Postoperative fever is common, occurring in approximately 1 in 5 pediatric surgical hospitalizations.
  • Surgical procedure type is a significant determinant of PoF incidence.
  • Prolonged operative time, younger patient age, lower weight Z scores, and a higher burden of chronic conditions are independently associated with an increased risk of PoF.