Noninfectious Fever Following Aortic Surgery:Incidence,Risk Factors,and Outcomes

Objective To determine the incidence,course,potential risk factors,and outcomes of noninfectious fever developed in patients after aortic surgery.Methods Patients who received operation for aortic aneurysm or dissection in our center from January 2006 to January 2008 were reviewed.Patients who met one of the following criteria were excluded:having a known source of infection during hospitalization;having a preoperative oral temperature greater than or equal to 38.0°C;undertaking emergency surgery;having incomplete data.Univariate analysis was performed in patients with noninfectious postoperative fever and those without,with respect to demographics,intraoperative data,etc.Risk factors for postoperative fever were considered for the multivariate logistic regression model if they had a P value less than 0.10 in the univariate analysis.Results Totally 463 patients undergoing aortic surgery were enrolled for full review.Among them,345(74.5%) patients had noninfectious postoperative fever,the other 118(25.5%) patients didn't develop postoperative fever.Univariate analysis demonstrated that several risk factors were associated with the development of noninfectious postoperative fever,including weight,surgical procedure,minimum intraoperative bladder temperature,temperature upon intensive care unit(ICU) admission,discharge,and during ICU stay,as well as blood transfusion.In a further multivariate analysis,surgical site of thoracic and thoracoabdominal aorta(odds ratio:4.861;95% confidence interval:3.029-5.801;P=0.004),lower minimum intraoperative bladder temperature(odds ratio:1.117;95% confidence interval:1.01-1.24;P=0.04),and higher temperature on ad-mission to the ICU(odds ratio:2.57;95% confidence interval:1.28-5.18;P=0.008) were found to be significant predictors for noninfectious postoperative fever.No difference was found between the febrile and afebrile patients with regard to postoperative hospitalization duration(P=0.558) or total medical costs(P=0.896).Conclusion Noninfectious postoperative fever following aortic surgery is very common and closely related with perioperative interventions.