title: Predictive value for infection of febrile morbidity after vaginal surgery.
abstract: OBJECTIVE
  To determine the screening value of febrile morbidity for detecting infections after vaginal surgery.
  
  
  METHODS
  A cohort of 431 consecutive women had vaginal surgery at the M. S. Hershey Medical Center from September 1988 through June 1995. Outcomes of febrile morbidity and infection were analyzed.
  
  
  RESULTS
  Fifty-four of 431 patients (12.5%) had febrile morbidity. Thirty-five infections (8.1%) were identified, of which only 13 were accompanied by febrile morbidity. Forty-one patients (9.5%) had unexplained fevers. The sensitivity of febrile morbidity for postoperative infection was 40%, specificity was 98%, positive predictive value was 26%, and negative predictive value was 94%. Stepwise logistic regression found blood loss (odds ratio 1.001/mL; confidence interval 1.0001-1.0035), uterine weight (0.987/g; 0.976-0.999), and parity (1.570; 1.146-2.050) as significant independent variables for developing fever. Patient weight (0.984/lb; 0.971-0.998) and type of procedure (2.16; 2.12-6.38) were confirmed as significant independent variables for postsurgical infections.
  
  
  CONCLUSIONS
  Febrile morbidity had limited value as a screening test for postoperative infection, with poor sensitivity and positive predictive value after vaginal surgery.
authors.affiliation: Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina 27858-4354, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Shackelford
authors.forename: M K
authors.initials: MK
authors.lastname: Hoffman
authors.forename: M F
authors.initials: MF
authors.lastname: Davies
authors.forename: P F
authors.initials: PF
authors.lastname: Kaminski
mesh_terms: D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007044:Hysterectomy; D007239:Infections / Q000150:complications / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014621:Vagina / Q000601:surgery*