Postoperative Inflammation and Fever After Elective Aortic Valve and Aortic Root Replacement: A Retrospective Cohort Study
Fever after cardiac surgery is common. More knowledge of postoperative fever could lead to better patient selection for diagnostic workup and empirical antibiotic treatment. We aimed to analyze the postoperative course of inflammation and fever after elective aortic valve and aortic root replacement...
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| Veröffentlicht in: | Open Forum Infectious Diseases 2023-01, Vol.10 (1), p.ofad015-ofad015 |
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| creator | Keijmel, Stephan P Zwartkruis, Iris M M Jongenotter, Jochem Geuzebroek, Guillaume S C Kouijzer, Ilse J E |
| description | Fever after cardiac surgery is common. More knowledge of postoperative fever could lead to better patient selection for diagnostic workup and empirical antibiotic treatment. We aimed to analyze the postoperative course of inflammation and fever after elective aortic valve and aortic root replacement.
In a retrospective single-center cohort study, we included 3 groups of patients after elective cardiac surgery: aortic root with aortic valve replacement (Bentall procedure, from 2014 to 2021), valve-sparing root replacement (VSRR, from 2014 to 2021), and isolated surgical aortic valve replacement (SAVR, from 2018 to 2021). Exclusion criteria were age |
| doi_str_mv | 10.1093/ofid/ofad015 |
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In a retrospective single-center cohort study, we included 3 groups of patients after elective cardiac surgery: aortic root with aortic valve replacement (Bentall procedure, from 2014 to 2021), valve-sparing root replacement (VSRR, from 2014 to 2021), and isolated surgical aortic valve replacement (SAVR, from 2018 to 2021). Exclusion criteria were age <18 years, cardiac surgery other than described, use of deep-hypothermic circulatory arrest, reoperations, and preexisting infections. Primary outcome measure was the number of patients per group with postoperative fever (≥38°C). Secondary outcome measures were the percentage of patients per group with infections and outcome.
Among 307 patients included (76 Bentall, 40 VSRR, 191 SAVR), 71% had postoperative fever. Fever occurred significantly more often in the Bentall (84%) and VSRR group (83%) compared with patients after SAVR (64%,
= .001). Seventeen patients had fever due to infection versus 202 with diagnoses of postoperative inflammation. In case of infection, fever was significantly higher (38.8°C vs 38.4°C,
= .03), and both the number of days with fever and hospital admission duration were significantly longer.
Postoperative fever is more often observed after Bentall procedure and VSRR compared to SAVR. In diagnoses of infection, there is a higher and prolonged fever.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofad015</identifier><identifier>PMID: 36726552</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Antibiotics ; Care and treatment ; Health aspects ; Heart valve diseases ; Inflammation ; Major</subject><ispartof>Open Forum Infectious Diseases, 2023-01, Vol.10 (1), p.ofad015-ofad015</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.</rights><rights>COPYRIGHT 2023 Oxford University Press</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-7caeb4f2a69f4556fa9fea94749ee7d209a23b43deeb7069911b4c3f3aa35d2b3</citedby><cites>FETCH-LOGICAL-c381t-7caeb4f2a69f4556fa9fea94749ee7d209a23b43deeb7069911b4c3f3aa35d2b3</cites><orcidid>0000-0002-1808-4076</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887259/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887259/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36726552$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keijmel, Stephan P</creatorcontrib><creatorcontrib>Zwartkruis, Iris M M</creatorcontrib><creatorcontrib>Jongenotter, Jochem</creatorcontrib><creatorcontrib>Geuzebroek, Guillaume S C</creatorcontrib><creatorcontrib>Kouijzer, Ilse J E</creatorcontrib><title>Postoperative Inflammation and Fever After Elective Aortic Valve and Aortic Root Replacement: A Retrospective Cohort Study</title><title>Open Forum Infectious Diseases</title><addtitle>Open Forum Infect Dis</addtitle><description>Fever after cardiac surgery is common. More knowledge of postoperative fever could lead to better patient selection for diagnostic workup and empirical antibiotic treatment. We aimed to analyze the postoperative course of inflammation and fever after elective aortic valve and aortic root replacement.
In a retrospective single-center cohort study, we included 3 groups of patients after elective cardiac surgery: aortic root with aortic valve replacement (Bentall procedure, from 2014 to 2021), valve-sparing root replacement (VSRR, from 2014 to 2021), and isolated surgical aortic valve replacement (SAVR, from 2018 to 2021). Exclusion criteria were age <18 years, cardiac surgery other than described, use of deep-hypothermic circulatory arrest, reoperations, and preexisting infections. Primary outcome measure was the number of patients per group with postoperative fever (≥38°C). Secondary outcome measures were the percentage of patients per group with infections and outcome.
Among 307 patients included (76 Bentall, 40 VSRR, 191 SAVR), 71% had postoperative fever. Fever occurred significantly more often in the Bentall (84%) and VSRR group (83%) compared with patients after SAVR (64%,
= .001). Seventeen patients had fever due to infection versus 202 with diagnoses of postoperative inflammation. In case of infection, fever was significantly higher (38.8°C vs 38.4°C,
= .03), and both the number of days with fever and hospital admission duration were significantly longer.
Postoperative fever is more often observed after Bentall procedure and VSRR compared to SAVR. In diagnoses of infection, there is a higher and prolonged fever.</description><subject>Antibiotics</subject><subject>Care and treatment</subject><subject>Health aspects</subject><subject>Heart valve diseases</subject><subject>Inflammation</subject><subject>Major</subject><issn>2328-8957</issn><issn>2328-8957</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpVkU1r3DAQhk1paEKaW8_Fxx66iT4sy-qhYJakCQQakrRXMZZHiYptuZJ2Ifn11XbdkCIYaUbPvIz0FsUHSk4pUfzMW9fnAD2h4k1xxDhrVo0S8u2r82FxEuMvQgilRBCp3hWHvJasFoIdFc83PiY_Y4DktlheTXaAccyJn0qY-vICtxjK1qYczwc0f6nWh-RM-ROGnOyopXDrfSpvcR7A4IhT-lK2OU3Bx3npXPvHjJZ3adM_vS8OLAwRT5b9uPhxcX6_vlxdf_92tW6vV4Y3NK2kAewqy6BWthKitqAsgqpkpRBlz4gCxruK94idJLVSlHaV4ZYDcNGzjh8XX_e686YbsTd5sACDnoMbITxpD07_fzO5R_3gt1o1jWRCZYFPi0DwvzcYkx5dNDgMMKHfRM2kpKoiQlQZPd2jDzCgdpP1WdHk1ePojJ_QulxvpawazpgiueHzvsHkX4oB7ctclOidxXpnsV4szvjH1295gf8Zyv8AsfOmgQ</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Keijmel, Stephan P</creator><creator>Zwartkruis, Iris M M</creator><creator>Jongenotter, Jochem</creator><creator>Geuzebroek, Guillaume S C</creator><creator>Kouijzer, Ilse J E</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1808-4076</orcidid></search><sort><creationdate>20230101</creationdate><title>Postoperative Inflammation and Fever After Elective Aortic Valve and Aortic Root Replacement: A Retrospective Cohort Study</title><author>Keijmel, Stephan P ; Zwartkruis, Iris M M ; Jongenotter, Jochem ; Geuzebroek, Guillaume S C ; Kouijzer, Ilse J E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-7caeb4f2a69f4556fa9fea94749ee7d209a23b43deeb7069911b4c3f3aa35d2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antibiotics</topic><topic>Care and treatment</topic><topic>Health aspects</topic><topic>Heart valve diseases</topic><topic>Inflammation</topic><topic>Major</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keijmel, Stephan P</creatorcontrib><creatorcontrib>Zwartkruis, Iris M M</creatorcontrib><creatorcontrib>Jongenotter, Jochem</creatorcontrib><creatorcontrib>Geuzebroek, Guillaume S C</creatorcontrib><creatorcontrib>Kouijzer, Ilse J E</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Open Forum Infectious Diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keijmel, Stephan P</au><au>Zwartkruis, Iris M M</au><au>Jongenotter, Jochem</au><au>Geuzebroek, Guillaume S C</au><au>Kouijzer, Ilse J E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Inflammation and Fever After Elective Aortic Valve and Aortic Root Replacement: A Retrospective Cohort Study</atitle><jtitle>Open Forum Infectious Diseases</jtitle><addtitle>Open Forum Infect Dis</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>10</volume><issue>1</issue><spage>ofad015</spage><epage>ofad015</epage><pages>ofad015-ofad015</pages><issn>2328-8957</issn><eissn>2328-8957</eissn><abstract>Fever after cardiac surgery is common. More knowledge of postoperative fever could lead to better patient selection for diagnostic workup and empirical antibiotic treatment. We aimed to analyze the postoperative course of inflammation and fever after elective aortic valve and aortic root replacement.
In a retrospective single-center cohort study, we included 3 groups of patients after elective cardiac surgery: aortic root with aortic valve replacement (Bentall procedure, from 2014 to 2021), valve-sparing root replacement (VSRR, from 2014 to 2021), and isolated surgical aortic valve replacement (SAVR, from 2018 to 2021). Exclusion criteria were age <18 years, cardiac surgery other than described, use of deep-hypothermic circulatory arrest, reoperations, and preexisting infections. Primary outcome measure was the number of patients per group with postoperative fever (≥38°C). Secondary outcome measures were the percentage of patients per group with infections and outcome.
Among 307 patients included (76 Bentall, 40 VSRR, 191 SAVR), 71% had postoperative fever. Fever occurred significantly more often in the Bentall (84%) and VSRR group (83%) compared with patients after SAVR (64%,
= .001). Seventeen patients had fever due to infection versus 202 with diagnoses of postoperative inflammation. In case of infection, fever was significantly higher (38.8°C vs 38.4°C,
= .03), and both the number of days with fever and hospital admission duration were significantly longer.
Postoperative fever is more often observed after Bentall procedure and VSRR compared to SAVR. In diagnoses of infection, there is a higher and prolonged fever.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>36726552</pmid><doi>10.1093/ofid/ofad015</doi><orcidid>https://orcid.org/0000-0002-1808-4076</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford Journals Open Access Collection; PubMed Central |
| subjects | Antibiotics Care and treatment Health aspects Heart valve diseases Inflammation Major |
| title | Postoperative Inflammation and Fever After Elective Aortic Valve and Aortic Root Replacement: A Retrospective Cohort Study |
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