Conservative management of postoperative Fever in gynecologic patients undergoing major abdominal or vaginal operations

Journal of the American College of Surgeons
James E KendrickJ Michael Straughn

Abstract

To develop a standardized protocol for management of postoperative fever in gynecology patients to decrease unnecessary diagnostic workups and empiric use of antibiotics. A prospective analysis of postoperative gynecology patients identified those who experienced fever (maximum temperature [T(max)] > 100.4 degrees 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 T(max) > 101 degrees F for > 48 hours, were evaluated and treated based on physical examination findings. 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 degrees F); none of these patients r...Continue Reading

References

May 12, 2001·American Journal of Obstetrics and Gynecology·A SchwandtJ Fanning
Jun 26, 2003·American Journal of Obstetrics and Gynecology·Sarah H de la TorreBarbara A Goff

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Citations

May 29, 2020·Open Forum Infectious Diseases·William F Wright, Paul G Auwaerter

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