1349. Utility of Post-Operative Fever after Craniosynostosis Repair

Authors: Nicholas Field, MD; Matthew Adamo, MD; Nataly Raviv (Albany, NY)

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.