{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:40:59Z","timestamp":1792204859444,"version":"4.4.0"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Fevers are common in the postoperative period, and adult data indicate that workup for an isolated fever is not warranted in the first 4 postoperative days (PODs). Pediatric literature on the subject similarly questions the value of further investigation during the first 2 PODs. The purpose of this study was to determine the incidence of acute fever in the postoperative pediatric neurosurgical population, as well as to assess the utility of performing further workup on these patients.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A single-institution retrospective study was performed to assess pediatric neurosurgery patients following surgical intervention for the diagnoses of craniosynostosis, Chiari malformation, and brain tumors from 2009 to 2018. Fevers were identified during the first 4 PODs and were defined as a temperature \u2265 38.0\u00b0C. The patient charts were queried for urinalysis and urine culture (UA\/Ucx), chest radiographs, blood cultures, CSF culture, respiratory viral panel, white blood cell (WBC) count, transfusion history, development of wound infection, and placement of external ventricular drains (EVDs) or lumbar drains. Thirty-day postoperative microbiology results and readmissions were reviewed. Descriptive statistics were performed using logistic regression analysis.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Two hundred thirty-five patients were evaluated, and 61% had developed fevers within the first 4 PODs. Thirty-eight (26.6%) of the 143 febrile patients underwent further workup, and those with high fevers (> 39.0\u00b0C) were more likely to undergo further evaluation, which most commonly included UA\/Ucx (21.7%). Approximately 1% (2\/235) of the patients were found to have an infection during the first 4 days, and 8 additional patients developed a complication following the initial 4 days and within the first 30 PODs. The development of infectious complications within the first 4 PODs did not correlate with acute postoperative fevers (p = 0.997), nor did the development of complications within the 30 days following surgery (p = 0.776); however, multiple days of acute postoperative fevers (p = 0.034) and the presence of an EVD (p = 0.001) were associated with the development of infectious complications within 30 days. Acute postoperative fevers were associated with EVD placement (p = 0.038), as well as blood product transfusions and an increased WBC count (p < 0.001).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Isolated fevers manifesting within the first 4 PODs are rarely associated with an infectious etiology. Additional factors should be taken into consideration when deciding to pursue further investigation.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.5.peds2019","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T03:08:59Z","timestamp":1601003339000},"page":"691-695","source":"Crossref","is-referenced-by-count":16,"title":["Postoperative fever workup in pediatric neurosurgery patients"],"prefix":"10.3171","volume":"26","author":[{"given":"Nataly","family":"Raviv","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Field","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Adamo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"Infect Control","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1017\/S0195941700063608","article-title":"A prospective study of postoperative fever in a general surgery department","volume":"6","author":"Galicier C","year":"1985","unstructured":"Galicier C, Richet H. A prospective study of postoperative fever in a general surgery department. Infect Control. 1985;6(12):487\u2013490.10.1017\/S0195941700063608"},{"issue":"7","key":"b2","series-title":"Infect Control","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1017\/S0195941700061749","article-title":"Evidence for the non-infectious etiology of early postoperative fever","volume":"6","author":"Garibaldi RA","year":"1985","unstructured":"Garibaldi RA, Brodine S, Matsumiya S, Coleman M. Evidence for the non-infectious etiology of early postoperative fever. Infect Control. 1985;6(7):273\u2013277.384740310.1017\/S0195941700061749"},{"key":"b3","series-title":"UpToDate","article-title":"Fever in the surgical patient","author":"Weed HG","unstructured":"Weed HG, Baddour LM, Ho VP. Fever in the surgical patient. UpToDate. November 25, 2019. Accessed July 10, 2020. https:\/\/www.uptodate.com\/contents\/fever-in-the-surgical-patient"},{"issue":"10","key":"b4","series-title":"Clin Infect Dis","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1086\/429621","article-title":"Diagnostic accuracy of routine postoperative body temperature measurements","volume":"40","author":"Vermeulen H","year":"2005","unstructured":"Vermeulen H, Storm-Versloot MN, Goossens A, Diagnostic accuracy of routine postoperative body temperature measurements. Clin Infect Dis. 2005;40(10):1404\u20131410.1584406110.1086\/429621"},{"issue":"4","key":"b5","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3171\/2016.11.PEDS16455","article-title":"Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery","volume":"19","author":"Sherrod BA","year":"2017","unstructured":"Sherrod BA, Rocque BG. Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery. J Neurosurg Pediatr. 2017;19(4):421\u2013427.2818647410.3171\/2016.11.PEDS16455"},{"issue":"3","key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"736","DOI":"10.3171\/2013.10.JNS122419","article-title":"Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011","volume":"120","author":"Rolston JD","year":"2014","unstructured":"Rolston JD, Han SJ, Lau CY, Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011. 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Fever in the postoperative patient. Emerg Med Clin North Am. 2013;31(4):1045\u20131058.10.1016\/j.emc.2013.07.01124176478"},{"issue":"7","key":"b9","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1016\/j.jpedsurg.2017.06.019","article-title":"Early postoperative fever workup in children: utilization and utility","volume":"53","author":"Corkum KS","year":"2018","unstructured":"Corkum KS, Hunter CJ, Grabowski JE, Lautz TB. Early postoperative fever workup in children: utilization and utility. 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