title: Incidence, risk factors, and diagnostic evaluation of postoperative fever in an orthopaedic trauma population.
abstract: OBJECTIVE
  To determine the incidence of positive diagnostic evaluations during the management of postoperatively febrile orthopaedic trauma patients. A secondary objective was to describe the incidence and risk factors for postoperative fever.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  The orthopaedic trauma service at a tertiary referral hospital.
  
  
  METHODS
  Postoperatively febrile orthopaedic trauma patients admitted from 2005 to 2008.
  
  
  METHODS
  In patients who developed postoperative fever (oral temperature ≥38.5ºC), records were reviewed to determine whether urinalysis, urine cultures, blood cultures, chest radiographs, or wound cultures were performed and subsequent results were recorded. Patient demographics including sex, age, and medical comorbidities were also noted.
  
  
  RESULTS
  A total of 106 subjects (18%) developed a postoperative fever, with a mean temperature of 38.8 ± 0.3ºC (range, 38.5-40.0ºC). Overall, 135 diagnostic tests were ordered with 14 being positive (10%). Yields per individual test were as follows: urinalyses, 7 of 34 (21%); urine cultures, 4 of 38 (11%); chest radiograph, 2 of 23 (9%); blood cultures, 1 of 38 (3%); and wound cultures, 0 of 2 (0%). Patients investigated on postoperative day 6 or later had a greater incidence of positive diagnostic evaluations (40%) than patients investigated on postoperative days 0-5 (16%). The single positive blood culture was found on postoperative day 16.
  
  
  CONCLUSIONS
  Postoperative fever is common among orthopaedic trauma patients. Diagnostic evaluations have a low-positive yield, particularly in the early postoperative period. In the later postoperative period, physicians should be more suspicious for an infective source of fever because a traumatic inflammatory etiology of fever is less likely.
authors: University of British Columbia, Department of Orthopaedic Surgery, Vancouver, BC, Canada.
authors: Robert
authors: R
authors: Petretta
authors: Mark
authors: M
authors: McConkey
authors: Gerard P
authors: GP
authors: Slobogean
authors: James
authors: J
authors: Handel
authors: Henry M
authors: HM
authors: Broekhuyse
mesh_terms: D001955:British Columbia / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000453:epidemiology*; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors