Title: Evaluation of Postoperative Fever in General Surgery Patients in Rajah Muthiah Medical College and Hospital, Chidambaram, Cuddalore, India

Authors: Dr Guru Praveen, Dr N. Junior Sundresh, Dr Gopi Krishna, Dr Logesh Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.41

Abstract

Background: Post operative fever is a common complication seen in the postoperative ward. Most of the cases of pyrexia following surgery are self limiting. The appearance of postoperative fever is not limited to specific types of surgery. Fever can occur immediately after surgery or may occur several days following surgery depending in the underlying cause which might be directly related to surgery or due to infection elsewhere in the body. Therefore, while evaluating for postoperative pyrexia, it is vital to recognize when work up is needed and when immediate intervention is needed.

Methods: The study on evaluation of post operative pyrexia is based on 110 patients admitted in Rajah Muthiah Medical College Hospital in Chidambaram during the period from November 2018 to September 2019,and who underwent surgery for various surgical conditions. The study includes 45 females and 65 males, all under the age group of 10 to 70 years.

Result: Between the study period, a total of 1300 major elective surgeries were performed at our hospital. Only 110 patients developed pyrexia in the postoperative period. Of the total number of patients (110) who developed pyrexia, 65 patients were males and the remaining 45 were female.

Conclusion: In the first 48 hours after surgery, postoperative fever is a common occurrence and the etiology can be difficult to establish in certain clinical situations. This causes great diagnostic dilemma to the surgeon. The occurrence of pyrexia in the postoperative period is not determined by age and sex of the patient. The presence of preoperative co morbidity determines the complication rate and delay in recovery from the fever.

Keywords: elective surgery, postoperative period, surgical site infection, sepsis.

References

  1. General Complications In:  Williams  NS,  Bulstrode CJK, O’Connell Short Practice of Surgery. 25th ed. Bailey and Love.264-265
  2. Bone RC, Balk RA, Cerra Definitions for sepsis and organ failure and  guidelines  for  the  use  of innovative therapies for       sepsis.   Chest 1992;101(6):1644-55.
  3. Barie Surgical site infections: Epidemiology and prevention. Surg Infect 2002;3(s1):9-21.
  4. Sikora C, Embil    Fever in the  postoperative patient: a chilling   problem.   Canadian   J   CME. 2004:93-96.
  5. Dinarello CA, Cannon JG, Wolff New concepts on the   pathogenesis   of   fever.   Rev   Infect   Dis.1988;10(1):168.
  6. Rudra A,  Pal  S,  Acharjee    Post Operative fever. Indian J Crit Care Med. 2006;10(4):264-71.
  7. Garibaldi RA, Brodine S Matsumiya S, Coleman Evidence for  the  non  infectious  etiology  of  early post  operative  fever.  Infect control.  1985; 6(7):273-7.
  8. Dauleh MI, Rahman  S,  Townell  H-Open versus Laparoscopic  cholecystectomy:   A  comparison  of postoperative      J  R   Coll   Surg   Edin. 1995; 40(2):116-8.
  9. Dellinger 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.
  10. Barie PS, Soumitra    Eachempati-  Surgical  Site Infections. Surg Clin North Ame. 2005;85(6):1115-35.
  11. Cranston WI,  Gerbrandy  J,  Snell    Oral, rectal and oesophageal temperatures   and   some   factors affecting them in man. J Physiol. 1954;126:347-58.
  12. Malone DL   Genuit   T,   Tracy      Surgical   site infections: Reanalysis of risk factors. J Surgical Res. 2002;103 (1):89-95.
  13. Pile Evaluating postoperative  fever:  A  focused approach. J Med. 2006;73:S62-6.
  14. Herve D, Philippe  M,  Remy  G,  Benoit  V,  Jean- Louis   P,  Claude     Outcome   of   postoperative pneumonia  in  the  Eole  study.  Intensive  Care  Med. 2003; 29:179-88.
  15. Fanning J, Neuhoff Frequency and yield of post operative fever    evaluation.    Infect Dis Obstet Gynecol. 1998; 6(6):252-5.

Corresponding Author

Dr N.Junior Sundresh

Professor, Dept of General Surgery, Rajah Muthiah Medical College and Hospital, Annamalai Nagar, Chidambaram, India, 608002