Fanning J, Neuhoff R A, Brewer J E, Castaneda T, Marcotte M P, Jacobson R L
Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo.
Infect Dis Obstet Gynecol. 1998;6(6):252-5. doi: 10.1002/(SICI)1098-0997(1998)6:6<252::AID-IDOG6>3.0.CO;2-4.
In women undergoing major gynecologic surgery, we wish to determine the frequency and yield of blood culture, urine culture, and chest X-ray evaluation of postoperative fever.
A retrospective review of 537 consecutive patients undergoing major gynecologic surgery was performed. In patients who developed postoperative fever, it was determined whether blood culture, urine culture, and/or chest X-ray were performed, and, if so, the frequency of positive results was evaluated.
Two hundred eleven patients (39%) developed postoperative fever. Blood cultures were obtained in 77 of 211 (37%) febrile patients, urine cultures in 106 of 211 (50%) febrile patients, and chest X-ray in 54 of 211 (26%) febrile patients. Zero of 77 blood cultures were positive, 11 of 106 (10%) urine cultures were positive, and 5 of 54 (9%) chest X-rays were positive. Logistic regression revealed that late onset fever predicted for positive urine cultures and early onset fever and advanced age predicted for pneumonia. Eighty percent of patients with pneumonia were symptomatic. In 92% of patients with postoperative fever, no infections or pathologic process were diagnosed.
Although postoperative fever is frequently evaluated by blood culture, urine culture, and chest X-ray, evaluation rarely yields positive results.
在接受大型妇科手术的女性患者中，我们希望确定血培养、尿培养及胸部X线检查对术后发热的检查频率及阳性率。
对537例连续接受大型妇科手术的患者进行回顾性研究。对于出现术后发热的患者，确定是否进行了血培养、尿培养及/或胸部X线检查，若进行了这些检查，则评估阳性结果的发生率。
211例患者（39%）出现术后发热。211例发热患者中，77例（37%）进行了血培养，106例（50%）进行了尿培养，54例（26%）进行了胸部X线检查。77份血培养结果均为阴性，106份尿培养中有11份（10%）呈阳性，54份胸部X线检查中有5份（9%）呈阳性。逻辑回归分析显示，迟发性发热提示尿培养阳性，早发性发热及高龄提示肺炎。80%的肺炎患者有症状。92%的术后发热患者未诊断出感染或病理过程。
尽管术后发热常通过血培养、尿培养及胸部X线检查进行评估，但检查结果很少呈阳性。
