Fever Is Common Postoperatively Following Posterior Spinal Fusion: Infection Is an Uncommon Cause - 25/02/15
Abstract |
Objective |
To determine the frequency and clinical significance of postoperative fever in pediatric patients undergoing posterior spinal fusion (PSF).
Study design |
A retrospective chart review was performed for consecutive patients undergoing PSF at a single institution between June 2005 and April 2011, with a minimum of 2-year follow up. Exclusion criteria were previous spine surgery, a combined anterior-posterior approach, and delayed wound closure at the time of surgery.
Results |
Two hundred and seventy-eight patients with an average age of 13 years (1-22 years) met inclusion criteria, with the following diagnoses: adolescent idiopathic scoliosis 43%, neuromuscular/syndromic scoliosis 39%, congenital scoliosis 11%, spondylolisthesis 4%, and Scheuermann kyphosis 3%. Seventy-two percent (201/278) of patients had a maximum temperature (Tmax) >38° postoperatively, and 9% (27/278) Tmax >39°. The percentage of febrile patients trended down following the first postoperative day. Infection rate was 4% (12/278). There was no correlation between Tmax >38° or Tmax >39°, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection.
Conclusion |
Seventy-two percent of pediatric patients undergoing PSF experienced postoperative fever, and 9% of patients had Tmax>39°. There was no significant correlation between fever and positive blood culture, urine culture, pneumonia, or surgical site infection. This information may help relieve stress for families and healthcare providers, and obviate routine laboratory evaluation for fever alone.
Le texte complet de cet article est disponible en PDF.Keyword : CXR, NMS, PSF, Tmax, UTI
Plan
| D.S. is a co-investigator for grants funded by the Pediatric Orthopaedic Society of North America and Scoliosis Research Society (paid to Columbia University); consultant for Biomet and Medtronic, board member for the Growing Spine Study Group, Growing Spine Foundation and Medtronic Strategic and Advisory Board; Committee Chair for the Scoliosis Research Society; provides expert testimony in medical malpractice cases (<5% of income); receives payment for lectures including service on speakers' bureaus for Biomet, Medtronic, and Stryker; patent holder for Medtronic; receives royalties from Wolters Kluwer Health-Lippincott Williams & Wilkins, receives payment for the development of educational presentations for Stryker, Biomet and Medtronic and receives institutional support from Medtronic (fellowship program). L.A. has Eli Lilly stocks. All remaining authors declare no conflicts of interest. |
Vol 166 - N° 3
P. 751-755 - mars 2015 Retour au numéro
Article précédent
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- Steven A. Abrams
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