Postoperative fever in pediatric orthopaedic patients

Fever in hospitalized patients causes a great deal of concern. Its value in predicting complications, however, is questionable. For this reason, a retrospective analysis was performed on 200 records of children's orthopaedic admissions. Demographic data, would status, fever work-up, and daily peak temperatures were recorded. There were 174 patients who underwent surgical procedures and 26 patients who did not have surgery. Seventy-three percent (127/174) of the surgical patients had postoperative fever [temperature > 38 degrees C (100.4 degrees F)] Twenty-seven percent of the nonsurgical patients had fever. There were only three acute complications--one pneumonia and two wound infections. Complications were easily diagnosed by clinical means. In postoperative patients, the accuracy in predicting complications was 28%. Postoperative fever is a poor predictor of complications, and, therefore, should not delay discharge or indicate investigation for sepsis.