Incidence and Distribution of Early Postoperative Fever in Three Hospitals in Al-Muthanna Governorate, Iraq: A Prospective Multicenter Exploratory Study

Abstract

Background: Early postoperative fevers are common and are often due to an inflammatory response related to surgical tissue injury rather than infection. However, the frequency rates vary according to patient population, procedure type, definition of fever and intensity of monitoring. In a purpose to estimate the incidence and distribution of fever within the first 48 h after surgery, this study gathered knowledge at three hospitals in southern Iraq.

Methods: A multicenter single-arm prospective observational study of 98 patients on elective or emergency surgery was undertaken from 10 December 2021 to 10 April 2022. Body temperature (°C) was measured at least twice daily on postoperative days 1 and 2 with standardized electronic thermometer orally. Fever was defined as any oral temperature of ≥38·0 °C within 48 h. Frequencies, percentages and Wilson 95% confidence intervals (CIs) were used to summarize results. All analyses were descriptive for procedures and ages with small strata; sex differences tested using Fisher's exact test.

Results: Early postoperative fever developed in 32 of 98 patients (32.7%; 95% CI 24.2–42.4). Fever occurred in 16 of 54 male patients (29.6%, 95% CI 19.1–42.8) and in 16 of 44 female patients (36·4%,95% CI23.8–51.1; oddsratio 1•36,95%CI0•58–3•17; Fisher'sexactp=0·52). Fever after orthopedic procedures occurred in a maximum of 6/15 (40.0%) procedure groups, the corresponding estimates being: caesarean section 12/31 (38.7%), appendectomy 4/14 (28.6%), cholecystectomy 2/7 (28.6%); hernia repair 3/14 (21.4%); and other procedures; both [0/10] [0%). The confidence intervals were generally wide, reflecting a large degree of imprecision.

Conclusions: About one third of the patients developed fever in 48 h after surgery. The differences across procedures were exploratory and equivocal, and the study did not identify independent predictors of fever. Recommendations for local diagnostic or management algorithms will need further evidence from larger procedure-specific studies that have used standardized temperature measurement and collected perioperative confounders.

Discipline: Post-operative fever; pyrexia; surgery; body temperature. observational study Keywords: Postoperative fever, postoperative pyrexia, surgical operation, Body Temperature Citation Trends in the incidence of early postoperative febrile morbidity in Al-Najaf center literary institute (ACLI) hospital over a five-year period between 2014 — 2021.