Related Experiment Videos
THe significance of fever following operations in children
Insights
Postoperative fever in children is common, occurring in 28.5% of cases. However, serious septic complications are rare, emphasizing clinical evaluation over routine lab tests for diagnosis.
Area of Science:
- Pediatric Surgery
- Infectious Disease Epidemiology
Background:
- Early postoperative fever is a common concern in pediatric surgical patients.
- Distinguishing infectious from non-infectious causes is clinically important.
Purpose of the Study:
- To determine the incidence and clinical significance of early postoperative fever in children.
- To identify risk factors associated with postoperative fever.
Main Methods:
- Prospective study of 256 children undergoing surgery.
- Monitoring clinical records for fever (>38°C) for 3 days post-op.
- 1-month follow-up for complications.
Main Results:
- 28.5% of children developed fever; only 1.6% had septic processes.
- Risk factors included longer operations (>2 hr), intraoperative transfusion, preexisting infection, and preoperative antibiotics.
- Fever etiology was primarily non-infectious, diagnosed via physical exam.
Conclusions:
- Postoperative fever in children has multiple causes beyond infection.
- Septic complications are infrequent, suggesting a conservative diagnostic approach.
- Clinical evaluation is paramount; lab investigations should be guided by suspected diagnoses.
Abstract:
To determine the incidence and clinical significance of early postoperative fever, all children (n = 256) undergoing surgery in the main operating theatres during a 4 wk period were studied. Admission and operating room data were reviewed and the clinical record was monitored at 12 hourly intervals for the first 3 postoperative days. The patients were followed for 1 mo for the development of recognizable complications. Seventy-three children (28.5%) developed fever greater than 38 degrees C but in only four (1.6%) did this represent a septic process. Physical examination led to the proper diagnosis in all. Risk factors that correlated statistically with postoperative fever were operation of greater than 2 hr (p less than .001), intraoperative transfusion (p less than .001), preexisting infection (p less than .01) and the use of preoperative antibiotics (p less than .001). Anatomic site of operation, age and sex were not significant factors. We conclude that many factors other than infection are responsible for post-operative fever. Further, only a very small proportion of children with early postoperative fever develop significant septic complications. In the assessment of postoperative fever a protocol which indiscriminately includes lab investigations and X-rays is costly and usually not diagnostic. Laboratory tests are indicated mainly to confirm diagnoses suspected by clinical evaluation.