title: Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery.
abstract: Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively. Fever (≥38 °C) occurred in 63 (17 %) patients. Most incidences of fever occurred on postoperative day one. In majority of these cases, the fever subsided after removal of the packing material without further antibiotic administration. However, one patient who experienced persistent fever after the removal of packing material developed meningitis. History of asthma, prolonged operation time (≥108 min), and intravenous cefazolin administration instead of cefmetazole were associated with postoperative fever. Odds ratios (ORs) for each were 2.3, 4.6, and 2.0, respectively. Positive preoperative bacterial colonization was associated with postoperative bacterial colonization on the packing material (OR 2.3). Postoperative fever subsided in most patients after removal of the packing material. When this postoperative fever persists, its underlying cause should be examined.
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan. kazuhiroe@gmail.com.|Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. kazuhiroe@gmail.com.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nomura
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Yurika
authors.initials: Y
authors.lastname: Yamanaka
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sekine
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Esu
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hara
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Department of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
authors.forename: Risako
authors.initials: R
authors.lastname: Kakuta
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Ozawa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Katori
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D001249:Asthma / Q000150:complications; D002437:Cefazolin / Q000008:administration & dosage; D015311:Cefmetazole / Q000008:administration & dosage; D004724:Endoscopy; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D013630:Tampons, Surgical / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D015311:Cefmetazole; D002437:Cefazolin
keywords: Antibiotics; Bacteria; Endoscopes; Fever; Infection; Surgery