DOI: http://dx.doi.org/10.18203/2349-2902.isj20182014

Evaluation of postoperative pyrexia in general surgery patients in Medicity Institute of Medical Sciences, Ghanpur, Medchal, India

J. Yadagiri Rao, Akshay Singh

Abstract


Background: Postoperative fever is one of the most common problems seen in the postoperative ward. Most cases of fever immediately following surgery are self-limiting. The appearance of postoperative fever is not limited to specific types of surgery. Fever can occur immediately after surgery and seen to be related directly to the operation or may occur sometime after the surgery as a result of an infection at the surgical site or infections that involve organs distant from the surgery. Therefore, during evaluating postoperative fever, it is important to recognize when a wait and see approach is appropriate, when further work-up is needed and when immediate action is indicated.

Methods: The study on the evaluation of postoperative pyrexia is based on 110 patients admitted in Mediciti Institute of Medical Sciences during the period from Jan’2015 to Jun’2016 and who underwent surgery for various surgical causes. The study includes 45 females and 65 males and covers an age group between 10-70 years.

Results: Between the period of Jan’2015 and Jun’2016, a total of 1022 major elective surgical procedures were performed at our hospital. Only 110 patients developed pyrexia in the post operative period. Of the total number of patients (110 cases) who developed pyrexia, 65 patients were males and the remaining 45 were females.

Conclusions: Postoperative pyrexia is a common occurrence in the first 48 hours after surgery and the etiology can be difficult to establish in certain clinical situations. This poses great diagnostic dilemmas to the operating surgeon. Age and Sex of the patient do not significantly influence the occurrence of pyrexia in the postoperative period. The more the number of preoperative co-morbid problems, the more is the complication rate and the delay in recovery from pyrexia.


Keywords


Appendectomy, Fever, Postoperative period, Thyroidectomy

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References


General Complications In: Williams NS, Bulstrode CJK, O’Connell PR. Short Practice of Surgery. 25th ed. Bailey and Love.264-265

Bone RC, Balk RA, Cerra RP. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies for sepsis. Chest 1992;101(6):1644-55.

Barie PS. Surgical site infections: Epidemiology and prevention. Surg Infect 2002;3(s1):9-21.

Sikora C, Embil JM. Fever in the postoperative patient: a chilling problem. Canadian J CME. 2004:93-96.

Dinarello CA, Cannon JG, Wolff SM. New concepts on the pathogenesis of fever. Rev Infect Dis. 1988;10(1):168.

Rudra A, Pal S, Acharjee A. Post Operative fever. Indian J Crit Care Med. 2006;10(4):264-71.

Garibaldi RA, Brodine S Matsumiya S, Coleman M. Evidence for the non infectious etiology of early post operative fever. Infect control. 1985;6(7):273-7.

8Dauleh MI, Rahman S, Townell H-Open versus Laparoscopic cholecystectomy: A comparison of postoperative temperature. J R Coll Surg Edin. 1995; 40(2):116-8.

Dellinger EP. Approach to the patient with postoperative fever. In: Gorbach SL, Barlett JG, Blacklow NR, editors. Infectious diseases. 3rd ed. Lippincott Williams and Wilkins: Philadelphia, PA; 2004:817.

Barie PS, Soumitra R. Eachempati- Surgical Site Infections. Surg Clin North Ame. 2005;85(6):1115-35.

Cranston WI, Gerbrandy J, Snell ES. Oral, rectal and oesophageal temperatures and some factors affecting them in man. J Physiol. 1954;126:347-58.

Malone DL Genuit T, Tracy JK. Surgical site infections: Reanalysis of risk factors. J Surgical Res. 2002;103 (1):89-95.

Pile JC. Evaluating postoperative fever: A focused approach. J Med. 2006;73:S62-6.

Herve D, Philippe M, Remy G, Benoit V, Jean-Louis P, Claude M. Outcome of postoperative pneumonia in the Eole study. Intensive Care Med. 2003; 29:179-88.

Fanning J, Neuhoff RA. Frequency and yield of post operative fever evaluation. Infect Dis Obstet Gynecol. 1998;6(6):252-5.