Related Experiment Videos
Frequency and yield of postoperative fever evaluation
J Fanning1, R A Neuhoff, J E Brewer
1Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo.
Infectious Diseases in Obstetrics and Gynecology
|February 11, 1999
Summary
Postoperative fever evaluation in gynecologic surgery patients using blood cultures, urine cultures, and chest X-rays rarely yields positive results. Most fevers in these patients do not indicate infection.
Area of Science:
- Gynecologic Surgery
- Infectious Disease Diagnosis
- Postoperative Care
Background:
- Postoperative fever is common after major gynecologic surgery.
- Diagnostic evaluation typically includes blood cultures, urine cultures, and chest X-rays.
Purpose of the Study:
- To determine the frequency and diagnostic yield of blood cultures, urine cultures, and chest X-rays in evaluating postoperative fever.
- To identify predictors of positive results and pneumonia.
Main Methods:
- Retrospective review of 537 patients undergoing major gynecologic surgery.
- Analysis of fever evaluation methods (blood culture, urine culture, chest X-ray) and their positivity rates.
- Logistic regression to identify predictors of positive cultures and pneumonia.
Main Results:
- 211 patients (39%) developed postoperative fever.
- Blood cultures were obtained in 37%, urine cultures in 50%, and chest X-rays in 26% of febrile patients.
- Positive results were rare: 0% for blood cultures, 10% for urine cultures, and 9% for chest X-rays. Late-onset fever predicted positive urine cultures; early-onset fever and advanced age predicted pneumonia.
Conclusions:
- Routine blood cultures, urine cultures, and chest X-rays for postoperative fever in gynecologic surgery patients have a low diagnostic yield.
- Most postoperative fevers in this cohort were not attributed to infection or a pathological process.