Transactions of the Sixty-Ninth Annual Meeting of the Pacific Coast Obstetrical and Gynecological SocietyEvaluation of postoperative fever: Usefulness and cost-effectiveness of routine workup☆
Section snippets
Material and methods
We conducted an 18-month retrospective chart review of women undergoing exploratory laparotomy by the Gynecologic Oncology and Benign Gynecology Services at the University of Washington Medical Center from November 1999 to May 2001. Approval from the Institutional Review Board was obtained through expedited review. All patients were included regardless of diagnosis or severity of illness. There were only two patients who had evidence of serious infections before surgery, one with pneumonia and
Results
A total of 676 patients underwent major gynecologic surgery through an abdominal incision from November 1999 to May 2001 and 196 patients (28.9%) met the criteria for febrile morbidity and 194 (28.6%) patients were used in the data analysis after 2 patients with preoperative infections were excluded. Of the 194 patients, 125 (64%) had a fever 38.5°C (101.3°F) or higher, 122 (63%) had a diagnosis of gynecologic cancer, and 21 (11%) underwent a bowel resection. Table I describes the patient
Comment
Fever is a normal host response to endogenous and exogenous pyrogens. An exogenous pyrogen is typically a microorganism or its byproducts and stimulates fever by inducing formation of an endogenous pyrogen. An endogenous pyrogen can be an immune complex, complement, steroid hormone metabolite, or cytokine and works by resetting the thermoregulatory center in the anterior hypothalamus. Interleukins 1 and 6 (IL-1, IL-6), tumor necrosis factor α and β and interferon alfa are the major pyrogenic
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Reprint requests: Barbara Goff, MD, Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Box 356460 University of Washington Medical Center, Seattle, WA 98195.