Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery

Kazuhiro Nomura, Yurika Yamanaka, Yasuhiro Sekine, Hiroki Yamamoto, Yoshihiko Esu, Mariko Hara, Masayo Hasegawa, Akihiro Shinnabe, Hiromi Kanazawa, Risako Kakuta, Daiki Ozawa, Hiroshi Hidaka, Yukio Katori, Naohiro Yoshida

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively. Fever (≥38 °C) occurred in 63 (17 %) patients. Most incidences of fever occurred on postoperative day one. In majority of these cases, the fever subsided after removal of the packing material without further antibiotic administration. However, one patient who experienced persistent fever after the removal of packing material developed meningitis. History of asthma, prolonged operation time (≥108 min), and intravenous cefazolin administration instead of cefmetazole were associated with postoperative fever. Odds ratios (ORs) for each were 2.3, 4.6, and 2.0, respectively. Positive preoperative bacterial colonization was associated with postoperative bacterial colonization on the packing material (OR 2.3). Postoperative fever subsided in most patients after removal of the packing material. When this postoperative fever persists, its underlying cause should be examined.

Original languageEnglish
Pages (from-to)167-173
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume274
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Antibiotics
  • Bacteria
  • Endoscopes
  • Fever
  • Infection
  • Surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Nomura, K., Yamanaka, Y., Sekine, Y., Yamamoto, H., Esu, Y., Hara, M., Hasegawa, M., Shinnabe, A., Kanazawa, H., Kakuta, R., Ozawa, D., Hidaka, H., Katori, Y., & Yoshida, N. (2017). Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery. European Archives of Oto-Rhino-Laryngology, 274(1), 167-173. https://doi.org/10.1007/s00405-016-4189-9