Incidence and Diagnosis of Postoperative Fever in an Orthopedic Trauma Population

Objective: To investigate the epidemiological status of postoperative fever in an orthopedic trauma population and explore the significance of related diagnostic evaluations. Methods: Among the 1396 orthopedic trauma patients,who were admitted during January 2011 and December 2013,there were 286 patients developing postoperative fever (oral temperature ≥38.5℃). In order to confirm the fever origin, urinalysis, urine cultures, blood cultures, wound cultures, and chest radiographs were performed and subsequent results were recorded. Results: Three hundred and sixty five diagnostic tests were ordered with 38 being positive(10.4%). Yields per individual test were as follows:urinalysis, 19/92 (20.6%); urine cultures, 11/103 (10.7%); chest radiograph, 5/62 (8.1%); blood cultures, 3/103 (2.9%); wound cultures, 0/5 (0%). Three patients with positive blood cultures had fever one week after operation. The positive rate of diagnostic evaluations in patients developing fever 6 d after operation (40%) was significantly higher than that in patients developing fever within 5 d (8.7%), the difference was significant (P＜0.01). Conclusion: Postoperative fever is common among orthopedic trauma patients. Fever developed in the early postoperative period may be caused by inflammatory reaction or early anemia, and the related diagnostic evaluations have a low-positive yield. If a fever was found 6 d after operation, then physicians should be vigilant against postoperative infection.