Neurospine.  2018 Jun;15(2):154-162. 10.14245/ns.1836026.013.

Postoperative Fever Evaluation Following Lumbar Fusion Procedures

Affiliations
  • 1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. kern.singh@rushortho.com

Abstract


OBJECTIVE
This study aimed to determine the incidence of postoperative fever, the workup conducted for postoperative fever, the rate of subsequent fever-related diagnoses or complications, and the risk factors associated with fever following lumbar fusion.
METHODS
A retrospective review of patients undergoing lumbar fusion was performed. For patients in whom fever (≥38.6°C) was documented, charts were reviewed for any fever workup or diagnosis. Multivariate regression was used to identify independent risk factors for the development of postoperative fever.
RESULTS
A total of 868 patients met the inclusion criteria, of whom 105 exhibited at least 1 episode of fever during hospitalization. The first documentation of fever occurred during the first 24 hours in 43.8% of cases, during postoperative hours 24-48 in 53.3%, and later than 48 hours postoperatively in 2.9%. At least 1 component of a fever workup was conducted in 47 of the 105 patients who had fever, resulting in fever-associated diagnoses in 4 patients prior to discharge. Three patients who had fever during the inpatient stay developed complications after discharge. On multivariate analysis, operations longer than 150 minutes (relative risk [RR], 1.66; p=0.015) and narcotic consumption greater than 85 oral morphine equivalents on postoperative day 0 (RR, 1.53; p=0.038) were independently associated with an increased risk of developing postoperative fever.
CONCLUSION
The results of this study suggest that inpatient fever occurred in roughly 1 in 8 patients following lumbar fusion surgery. In most cases where a fever workup was performed, no cause of fever was detected. Longer operative time and increased early postoperative narcotic use may increase the risk of developing postoperative fever.

Keyword

Lumbar fusion; Postoperative fever; Infection; Complication; Urinary tract infection; Pulmonary embolism

MeSH Terms

Diagnosis
Fever*
Hospitalization
Humans
Incidence
Inpatients
Morphine
Multivariate Analysis
Operative Time
Pulmonary Embolism
Retrospective Studies
Risk Factors
Urinary Tract Infections
Morphine
Full Text Links
  • NS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr