Analysis Of The Risk Factors Of Postoperative Fever After Posterior Lumbar Decompression Fusion Internal Fixation

objective: The study retrospectively analyzed the clinical information and data of patients after posterior lumbar decompression fusion internal fixation.Investigate the characteristics and trends of postoperative fever of lumbar posterior arthrodesis,analyzing and obtaining the risk factors of postoperative fever to provide the reference for clinic,and reduce the risk of postoperative fever,unnecessary examinations and the waste of medical resources to a certain extent.Methods: This study used a retrospective analysis to the clinical data of 120 patients(57 males and 63 females,aged 60.08 ± 11.565 years,from 23 to 84 years)who underwent posterior lumbar interbody fusion.surgery due to lumbar stenosis,lumbar disc herniation and lumbar spondylolisthesis at the spinal surgery department of North Jiangsu People’s Hospital from September 2018 to October 2019,including: Sex,age,body mass index(BMI),smoking,alcohol consumption,diabetes mellitus,preoperative albumin level,number of vertebral segments responsible for surgery,operative duration,intraoperative blood loss,loss of hemoglobin value,length of postoperative drainage tube placement,allogeneic transfusion and infection.According to the postoperative body temperature,the patients were divided into the febrile group and the non-febrile group.The postoperative daily average highest temperature were analyzed respectively with the preoperative day average highest temperature by paired t-test.The infected and uninfected group of the postoperative febrile patient were analyzed by group t-test.Postoperative fever cases with information such as gender,age,BMI,infection with high fever,respiratory infections and smoking,urinary tract infection and the indwelling catheters time using chi-square test or Fisher’s exact test,select statistically significant risk factors for multiple factors after binary Logistic regression analysis,it is concluded that the major risk factors of postoperative fever.Results: 1.Among the 120 patients,96 had fever and the fever rate was 80.0%.There was a significant difference between preoperative and postoperative body temperature(P < 0.05);2.After chi-square test,it was found that body mass index(BMI),diabetes mellitus,preoperative albumin level,operative responsibility vertebral segment number,operative time,intraoperative blood loss,postoperative hemoglobin loss,blood transfusion and postoperative infection were risk factors for postoperative fever(P <0.05);3.Multivariate binary logistic regression analysis showed that BMI,the number of operative vertebral segments and postoperative hemoglobin loss were the main risk factors for postoperative fever(P < 0.05);4.Postoperative high fever with infection in all 15 cases,6 cases of patients with high fever,high fever rate 40%,81 cases of patients with no postoperative infection,the patients with high fever in 1 case,high rate of 1.23%,incidence of postoperative infection in patients with high fever were significantly higher than those without infection,through the analysis of Chi-square test,postoperative infection and postoperative fever exists significant correlation(P < 0.01);5.There were 5 cases of respiratory infection(30%),6 cases of urinary infection(40%),2 cases of incision infection(13.33%),and 2 cases of urinary + superficial incision infection(13.33%).All cases of infection developed fever.One of the 5 patients with pulmonary infection had a history of smoking,and no correlation was found between the two(P > 0.05)(Table 4).Urinary tract infection occurred in 8 patients,only1 of whom had urinary catheter indwelling < 3 days,and the rest were all ≥3 days,both of which had statistical significance(P < 0.05)(Table 5).Conclusion: 1.BMI,diabetes mellitus,preoperative albumin level,operative segment number,operative time,intraoperative blood loss,hemoglobin loss,blood transfusion,and infection are risk factors for fever after lumbar posterior decompression fusion internal fixation.BMI,number of surgical segments,and hemoglobin loss are major risk factors for fever after lumbar posterior decompression fusion internal fixation;2.Postoperatively,the body temperature of the patients was higher than that of the patients before the operation,and the body temperature of the patients with postoperative infection was higher than that of the patients without postoperative infection.Postoperative body temperature of > 39℃,the possibility of infection is high.Pay attention to urinary tract infection and control the catheterization time;3.Patients with fever one week after surgery should be on alert for possible infection.