1349. Utility of Post-Operative Fever after Craniosynostosis Repair
Authors: Nicholas Field, MD; Matthew Adamo, MD; Nataly Raviv (Albany, NY)
Craniosynostosis is the premature fusion of one or more cranial sutures. Surgical management involves early cranial vault reconstruction. Post-operative care of these patients is often complicated by fever of unknown origin and results in additional laboratory studies, extended hospital ICU stays, and increased cost to the patient.
A retrospective analysis of seventy consecutive patients who underwent cranial vault reconstruction were included. Post-operative fever (Tmax), length of stay, transfusions, and white blood cell counts were obtained, as well as blood, urine, and other culture data.
Mean age at surgery was 1.1 years. Sixty (86%) patients had idiopathic post-operative fevers greater than 38 degrees Celsius. Of those, 13 underwent fever workups, none of which returned a positive culture or concern for pneumonia. Length of stay was significantly increased in those patients who had fever workups (5.92 days vs. 4.77, P < .002). There was no significant difference in age, Tmax, white blood cell count, and day of post-op fever between groups. The average estimated cost of a fever workup at our institution is 1187 USD.
Fever of unknown origin is a common finding after craniosynostosis repair. Workup for fever of unknown did not result in the identification of an infection and added significantly to the cost and patient’s length of stay.