Junghan Seo1, Jin Hoon Park2, Eun Hee Song3, Young-Seok Lee4, Sang Ku Jung5, Sang Ryong Jeon1, Seung Chul Rhim1, Sung Woo Roh1. 1. Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, Korea. Electronic address: grandblue@gnah.co.kr. 3. Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, Korea. 4. Department of Neurological Surgery, Gyeongsang National University School of Medicine, Jinju, Korea. 5. Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, Korea.
Abstract
BACKGROUND: Although there are many postoperative febrile causes, surgical-site infection has always been considered as one of the major causes, but it should be excluded; we encountered many patients who showed delayed postoperative fever that was not related to wound infection after spinal surgery. We aimed to determine the incidence of delayed postoperative fever and its characteristics after spinal surgery, and to analyze the causal factors. METHODS: A total of 250 patients who underwent any type of spinal surgery were analyzed. We determined febrile patients as those who did not show any fever until postoperative day 3, and those who showed a fever with an ear temperature of greater than 37.8°C at 4 days after surgery. We collected patient data including age, sex, coexistence of diabetes mellitus or hypertension, smoking history, location of surgical lesion (e.g., cervical, thoracic, lumbar spine), type of surgery, surgical approach, diagnosis, surgical level, presence of revision surgery, operative time, duration of administration of prophylactic antibiotics, and the presence of transfusion during the perioperative period, with a chart review. RESULTS: There were 33 febrile patients and 217 afebrile patients. Multivariate logistic regression showed that surgical approach (i.e., posterior approach with anterior body removal and mesh graft insertion), trauma and tumor surgery compared with degenerative disease, and long duration of surgery were statistically significant risk factors for postoperative nonpathologic fever. CONCLUSIONS: We suggest that most spinal surgeons should be aware that postoperative fever can be common without a wound infection, despite its appearance during the late acute or subacute period.
BACKGROUND: Although there are many postoperative febrile causes, surgical-site infection has always been considered as one of the major causes, but it should be excluded; we encountered many patients who showed delayed postoperative fever that was not related to wound infection after spinal surgery. We aimed to determine the incidence of delayed postoperative fever and its characteristics after spinal surgery, and to analyze the causal factors. METHODS: A total of 250 patients who underwent any type of spinal surgery were analyzed. We determined febrile patients as those who did not show any fever until postoperative day 3, and those who showed a fever with an ear temperature of greater than 37.8°C at 4 days after surgery. We collected patient data including age, sex, coexistence of diabetes mellitus or hypertension, smoking history, location of surgical lesion (e.g., cervical, thoracic, lumbar spine), type of surgery, surgical approach, diagnosis, surgical level, presence of revision surgery, operative time, duration of administration of prophylactic antibiotics, and the presence of transfusion during the perioperative period, with a chart review. RESULTS: There were 33 febrile patients and 217 afebrile patients. Multivariate logistic regression showed that surgical approach (i.e., posterior approach with anterior body removal and mesh graft insertion), trauma and tumor surgery compared with degenerative disease, and long duration of surgery were statistically significant risk factors for postoperative nonpathologic fever. CONCLUSIONS: We suggest that most spinal surgeons should be aware that postoperative fever can be common without a wound infection, despite its appearance during the late acute or subacute period.
Authors: Jung Jae Lee; Jeong Hee Kim; Ju Hee Jeon; Myeong Jong Kim; Byong Gon Park; Sang Ku Jung; Sang Ryong Jeon; Sung Woo Roh; Jin Hoon Park Journal: Medicine (Baltimore) Date: 2022-05-20 Impact factor: 1.817
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