Nanjing Children's Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China.
Children's Hospital of Nanjing Medical University, Nanjing, China.
Ital J Pediatr. 2023 Sep 13;49(1):120. doi: 10.1186/s13052-023-01524-6.
Our study aimed to compare the prevalence of postoperative fever during the COVID-19 pandemic period with that of the preceding non-pandemic period.
A retrospective analysis was conducted on patients with pectus excavatum (PE) undergoing minimally invasive repair (also called NUSS procedure) at Nanjing Children's Hospital from January 1, 2017 to March 1, 2019 (Group 2019), and from January 1, 2020 to March 1, 2021 (Group 2021). Data from a total of 284 patients, consisting of 200 (70.4%) males and 84 (29.6%) females with an average age of 9.73 ± 3.41 (range, 4 to 17) years, were collected. The presence of post-operative fever (defined as a forehead temperature of 37.5℃ or above within 72 h post-surgery), as well as the time of operation, duration of postoperative mechanical ventilator and urinary catheter use, and length of hospitalization were all assessed in admitted patients from Group 2019 (n = 144) and Group 2021 (n = 140). Postoperative white blood cell (WBC), C-reactive protein (CRP) levels, and prevalence of postoperative complications (i.e., pneumothorax, pulmonary atelectasis, pneumonia, wound infection, and dehiscence) were also determined.
Our results showed a statistically significant decrease in the incidence of postoperative fever within 24 to 72 h of surgery in patients admitted from Group 2019 as compared to Group 2021 (p < 0.001), as well as a decrease in peak body temperature within 72 h (p < 0.05). Meanwhile, no significant differences were observed in age and body mass index (BMI), time of operation, or duration of postoperative mechanical ventilator and urinary catheter use between the two groups (p > 0.05). The average hospitalization length of Group 2021 was significantly shorter than Group 2019 (12.49 ± 2.57 vs. 11.85 ± 2.19 days, p < 0.05). Furthermore, while the WBC count between the two groups 24 h after surgery showed a statistical difference (p < 0.05), no differences in CRP levels or the incidence of postoperative complications were observed (p > 0.05).
The prevalence of postoperative fever within 72 h of surgery and the length of hospital stay for patients with PE undergoing NUSS surgery were both decreased in Group 2021. We propose that the above phenomenon may be related to increased used of personal protection equipment (such as surgical masks and filtering facepiece respirators (FFRs)) by physicians, nurses, and the patients themselves.
本研究旨在比较 COVID-19 大流行期间与大流行前非流行期间术后发热的发生率。
回顾性分析 2017 年 1 月 1 日至 2019 年 3 月 1 日（2019 组）和 2020 年 1 月 1 日至 2021 年 3 月 1 日（2021 组）在南京儿童医院接受微创修复（也称为 NUSS 手术）的漏斗胸（PE）患者。共收集了 284 例患者的数据，其中男 200 例（70.4%），女 84 例（29.6%），平均年龄为 9.73±3.41 岁（范围为 4 至 17 岁）。评估了 2019 组（n=144）和 2021 组（n=140）入院患者的术后发热（定义为术后 72 小时内额温 37.5℃或以上）、手术时间、术后机械通气和导尿时间、住院时间。还确定了术后白细胞（WBC）、C 反应蛋白（CRP）水平和术后并发症（气胸、肺不张、肺炎、伤口感染和裂开）的发生率。
我们的结果显示，与 2021 组相比，2019 组术后 24 至 72 小时内发热的发生率有统计学意义下降（p<0.001），72 小时内体温峰值也有下降（p<0.05）。同时，两组间年龄和体重指数（BMI）、手术时间或术后机械通气和导尿时间无显著差异（p>0.05）。2021 组的平均住院时间明显短于 2019 组（12.49±2.57 天 vs. 11.85±2.19 天，p<0.05）。此外，两组术后 24 小时白细胞计数有统计学差异（p<0.05），但 CRP 水平或术后并发症发生率无差异（p>0.05）。
NUSS 手术后 72 小时内手术患者发热和住院时间均缩短。我们提出，这种现象可能与医生、护士和患者自身对个人防护设备（如手术口罩和过滤式呼吸防护器（FFR））的使用增加有关。
