The value of postoperative fever evaluation.

Area of Science:

• Medicine
• Surgical Oncology
• Infectious Diseases

Background:

• Postoperative fever evaluation often involves extensive diagnostic testing.
• The clinical utility and cost-effectiveness of these tests require examination.

Purpose of the Study:

• To assess the clinical usefulness and cost-effectiveness of diagnostic tests for early postoperative fever.
• To determine the impact of routine testing on patient outcomes and healthcare expenditure.

Main Methods:

• Retrospective review of 464 patients undergoing abdominal surgery.
• Analysis of fever incidence (rectal temperature ≥38.5°C) within the first six postoperative days.
• Correlation of fever source with diagnostic test results and clinical findings.

Main Results:

• 15% (71/464) of patients developed postoperative fever.
• Culture-proven infection accounted for fever in 27% (19/71) of febrile patients.
• Clinical findings and single tests diagnosed 74% (14/19) of infections; others required extensive testing.
• Unnecessary tests led to excess expenditure of $19,738 ($278 per febrile patient).

Conclusions:

• Routine diagnostic evaluations for postoperative fever do not significantly alter patient outcomes for the majority.
• Current testing strategies are not cost-effective, highlighting the need for a more targeted approach.
• Clinical assessment combined with judicious use of diagnostic tests is recommended for managing postoperative fever.