Conservative Management of Postoperative Fever in Gynecologic Patients Undergoing Major Abdominal or Vaginal Operations

James E. Kendrick, T. Michael Numnum, Jacob M. Estes, Kristopher Kimball, Charles A. Leath, J. Michael Straughn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: To develop a standardized protocol for management of postoperative fever in gynecology patients to decrease unnecessary diagnostic workups and empiric use of antibiotics. Study Design: A prospective analysis of postoperative gynecology patients identified those who experienced fever (maximum temperature [Tmax] > 100.4°F). Patients were triaged into low- and high-risk groups. High-risk patients were managed independent of the protocol. High-risk criteria included bowel operation, preoperative infection, immunodeficiency, indwelling vascular access, mechanical heart valves, and intensive care unit admissions. Low-risk patients were treated with observation and antipyretics. Patients with persistent or high fever, defined as Tmax > 101°F for > 48 hours, were evaluated and treated based on physical examination findings. Results: We evaluated 292 postoperative patients. Forty-seven percent of patients had a final diagnosis of malignancy. Sixty-four patients were high-risk and 33% of these patients experienced fever. Using the standardized protocol, 228 low-risk patients were managed. Thirty-seven of the 228 patients (16%) had fever postoperatively. Nineteen patients had low-grade fever (100.4 to 101°F); none of these patients required antibiotics. Seventeen patients had fever (101.1 to 102°F) and one patient had fever > 102°F. Using the protocol, 6 of 37 patients (16%) were treated with antibiotics for an infectious diagnosis. Conclusions: Although postoperative fever is common in gynecologic patients, the incidence of infection is low (3%). A standardized postoperative fever protocol in low-risk gynecology patients decreases use of empiric antibiotics without compromising morbidity.

Original languageEnglish (US)
Pages (from-to)393-397
Number of pages5
JournalJournal of the American College of Surgeons
Volume207
Issue number3
DOIs
StatePublished - Sep 1 2008

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Fever
Gynecology
Conservative Treatment
Anti-Bacterial Agents
Antipyretics
Heart Valves
Infection
Physical Examination
Blood Vessels
Intensive Care Units

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Conservative Management of Postoperative Fever in Gynecologic Patients Undergoing Major Abdominal or Vaginal Operations. / Kendrick, James E.; Numnum, T. Michael; Estes, Jacob M.; Kimball, Kristopher; Leath, Charles A.; Straughn, J. Michael.

In: Journal of the American College of Surgeons, Vol. 207, No. 3, 01.09.2008, p. 393-397.

Research output: Contribution to journalArticle

Kendrick, James E. ; Numnum, T. Michael ; Estes, Jacob M. ; Kimball, Kristopher ; Leath, Charles A. ; Straughn, J. Michael. / Conservative Management of Postoperative Fever in Gynecologic Patients Undergoing Major Abdominal or Vaginal Operations. In: Journal of the American College of Surgeons. 2008 ; Vol. 207, No. 3. pp. 393-397.
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