Normal postoperative febrile response in the pediatric orthopaedic population

Postoperative fever in the pediatric orthopaedic population remains a clini cal concern even though prior studies concluded that fevers are a poor pred ictor of surgical complications. In this retrospective study of 177 patient s, we established guidelines regarding the degree and time course of fever we should expect based on the perioperative conditions of magnitude of surg ery, duration of surgery, need for intraoperative transfusion, estimated bl ood loss, age, and gender. To provide a more sensitive assessment of fever, we developed composite temperature curves for each patient and defined the area under these curves as the total febrile response (TFR). This allowed us to assess fever as a cumulative event, taking into account both its magn itude and duration. A multivariate model then determined that of the periop erative conditions studied, intraoperative transfusion status and estimated blood loss were most helpful in predicting a patient's TFR. The results of this study can be used as an additional tool for assessing postoperative p rogress and whether a fever is within the normal limits indicated by a pati ent's perioperative variables.