title: Early pyrexia after endovascular aneurysm repair: are cultures needed?
abstract: BACKGROUND
  The post-implantation syndrome after endovascular aneurysm repair (EVAR) is increasingly recognised. However, when non-vascular trainees are responsible for the care of these patients out of hours, many are investigated if pyrexial. This study assesses the role of microbiological  investigations in pyrexia after endovascular aneurysm repair.
  
  
  METHODS
  The notes of 75 EVAR patients were reviewed retrospectively. The incidence of postoperative pyrexia and infective complications were calculated and the result of any cultures obtained.
  
  
  RESULTS
  Overall,  58 (77.3%) patients were pyrexial with 48 h of stent insertion. Twenty-four had blood cultures and 12 had urine cultures taken within 48 h of surgery. All of these cultures were negative. However, of those with a pyrexia after 48 h, one of nine blood cultures and two of 11 urine cultures grew  organisms. Five pyrexial patients and one apyrexial patient developed a wound infection (a non-significant difference, P = 1.00).
  
  
  CONCLUSIONS
  Pyrexia within 48 h of EVAR is common. Microbiological investigation in the first 48 h in these patients is unrewarding. After 48 h, cultures  are more likely to show growth. Although each patient must be assessed clinically for signs of sepsis, blood and urine cultures within 48 h of EVAR are generally unnecessary.
authors.affiliation: Department of Vascular Surgery, Kent and Canterbury Hospital, Canterbury, Kent, UK. lcorfield@doctors.org.uk
authors.forename: L
authors.initials: L
authors.lastname: Corfield
authors.forename: J
authors.initials: J
authors.lastname: Chan
authors.forename: T
authors.initials: T
authors.lastname: Chance
authors.forename: N
authors.initials: N
authors.lastname: Wilson
mesh_terms: D000783:Aneurysm / Q000601:surgery*; D001431:Bacteriological Techniques / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005334:Fever / Q000382:microbiology*; D006801:Humans; D011183:Postoperative Complications / Q000382:microbiology*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology