Abstract: Objective To determine the incidence, course, potential risk factors and outcomes of postoperative noninfectious fever in aortic surgical patients. Methods We reviewed 549 patients who received operation for aortic aneurysm or dissection in Beijing FuWai Cardiovascular Disease Hospital from January 2006 to January 2008. After excluding patients with a known source of infection during hospitalization, patients who had preoperative oral temperature greater than or equal to 38.0℃, patients who underwent emergency surgery, patients who died of other reasons other than feverrelated factors, and patients with incomplete data, we finally enrolled a total of 463 patients for final analysis. Depending on whether the patients developed a noninfectious fever after operation, we classified them into the febrile group (n=345, highest oral temperature ranging from 38.0-39.3℃) and the afebrile group (n=118, without postoperative fever). Univariate analysis was performed between these two groups of patients, with respect to demographics, operative data and postoperative conditions. Risk factors for postoperative fever were considered for the multivariate logistic regression model if they had a P value≤0.001 in the univariate analysis. Results After operation, 74.5%(345/463) of the patients had noninfectious fever. The minimum temperature of febrile patients on the operation day and the first postoperative day were both higher than afebrile patients(P=0.000,0.000). The maximum temperature of febrile patients on the operation day, the first, second,third and fourth postoperative days were also higher than afebrile patients(P=0.000,0.000, 0.047, 0.018). Univariate analysis demonstrated that weight (P=0.000), surgical type (P=0.000), minimum intraoperative bladder temperature (P=0.000), temperature upon ICU admission (P=0.000) and blood transfusion (P=0.000) were all risk factors for noninfectious postoperative fever. The multivariate logistic regression showed that surgical sites of thoracic and thoracoabdominal aorta (odds ratio: 4861; 95% confidence interval: 3.029,5.801; P=0.004), lower minimum intraoperative bladder temperature (odds ratio: 1.117; 95% confidence interval:1.013,1.244;P=0.040) and higher temperature on admission to the ICU (odds ratio: 2.570; 95% confidence interval:1.280,5.182;P=0.008) were significant predictors for postoperative noninfectious fever. Conclusion Noninfectious postoperative fever following aortic surgery is very common. Predictors of noninfectious postoperative fever following aortic surgery include surgical sites (thoracic or thoracoabdominal aorta), low intraoperative core temperature and temperature elevation in the immediate postoperative period.
Citation: YAO Yuntai,LI Lihuan,LEI Qian,et al .. Clinical Research on Noninfectious Fever Following Aortic Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2010, 17(2): 99-104. doi: Copy