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Is fever a normal finding in the immediate post-operative period after craniosynostosis repair?
Ali M. Ayyash, MPH; Mostafa Haredy, MD; Justin Daggett, MD; Joseph E. Losee; Jesse A. Goldstein, MD
University of Pittsburgh
2018-02-15
Presenter: Ali Maher Ayyash
Affidavit:
Ali M. Ayyash
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: Fever after craniosynostosis surgery is considered by most clinicians to be an undesirable complication, leading to prolonged hospital stays and costly work-ups. However, the etiology of post-operative fever in these patients is not always understood and may be benign. This study aims to show that fever is a common and often benign outcome in the immediate post-operative period after craniosynostosis surgery.
Methods: A retrospective analysis was conducted on patients ages 0-20 receiving open craniosynostosis surgery between January 2012-December 2016 at the University of Pittsburgh Medical Center Children's Hospital. Procedures included: fronto-orbital advancement, vault reverse pi, anterior/middle/posterior vaults, anterior cranioplasty, strip craniectomy, and facial bipartition with monobloc distraction.
Results: 149 patients were included in the study. The average age at surgery was 2.65 years with 127(85.23%) non-syndromic and 22(14.77%) syndromic patients. Suture involvement included sagittal(52.35%), right coronal(28.86%), metopic(27.52%), left coronal(24.83%), right lambdoid(8.05%), and left lambdoid(8.72%). A total of 89/149(59.73%) patients developed a fever (>38°C) in the immediate post-operative period (Day 0- Day 7). The incidence of fever was greatest on post-op Day 1(60.67%) and Day 0(19.10%). Procedure length(p=0.170), procedure type(p=0.372), syndromic diagnosis(p=0.686), and quantity of red blood cells transfused per kilogram(p=0.066) were not predictive of fever development. Age at intervention was a significant predictor of fever development(p=0.014).
Conclusions: Fever is a common and often benign finding after open craniosynostosis repair. Clinicians should consider this outcome when evaluating and caring for craniosynostosis patients in the immediate post-operative period.
