Background:
Surgeons in the perioperative management of their patients are increasingly involving hospitalist physicians. This relationship includes preoperative assessments and postoperative referrals or comanagement for medical conditions including fevers, diabetes, hypertension, and coronary artery disease. The purpose of the study was to document the incidence and clinical predictors of postoperative fevers in adult patients undergoing elective hip or knee surgery.
Methods:
The study was a retrospective chart review of consecutive elective hip or knee surgeries from January 2004 to December 2005 at a 100‐bed community teaching hospital with 2 independent orthopedic practices and an academic hospitalist group. The charts of a total of 98 eligible adult patients were reviewed during this period. These patients had their preoperative assessments or updates done by the hospitalist physicians prior to surgery. Data collected included postoperative fever (defined as a temperature greater than 100.4°F [38.0°C]); type of surgery; complications; average length of stay; comorbidities including diabetes, hypertension, chronic kidney disease, and coronary artery disease; indication for surgery; age; sex; and orthopedic group.
Results:
The incidence of postoperative fever was 68%; however, this was not associated with any documented infection. There were no independent predictors of postoperative fever in our logistic regression model including age, sex, comorbid conditions, orthopedic practice, and type of surgery.
Conclusions:
Postoperative fever is common and not necessarily associated with infection. Thus, when consulted to evaluate fever in elective orthopedic patients, a physician is warranted to perform a careful history, physical exam, and review of the patient's chart for pertinent clues before ordering additional tests or medications.
Author Disclosure:
J. K. Halm, Pfizer, speakers bureau; BIPI, speakers bureau; SCIOS, speakers bureau.