Temperature Measurement Timings Determine the Fever Detection Rate after Gastrointestinal Surgery: A Retrospective Cross-Sectional Study (Preprint)

Abstract

Postoperative fever can either be detected by medical staff intermittently or by sensors continuously. What is the fever detection rate under intermittent measurement?

To investigate the fever detection rate under intermittent measurement and to investigate the clinical relevance of the detected fever.

The clinical record of patients who underwent nonemergency gastrointestinal surgery between November 2020 and April 2021 were retrospectively reviewed. The temperature data of the patients that were collected by the sensor were retrieved. Fever was defined whenever temperature exceeded 38.0℃ in one day. To simulate the intermittent measurement in clinical work, body temperature on every hour were picked from the continuously collected temperature data set. Considering that temperature are measured several times per day, every possible measurement plan by intermittent measurement was composed by combining 1 to 24 time points from the 24 hours daily, and fever was diagnosed base on the temperature on the selected time points per day. Fever detection rates of every plans with varied measurement times were listed and ranked.

Based on the temperature data that were continuously collected by the sensors, fever occurred in 60 (40.82%) of the included 147 patients within three days after surgery. The detection rate of the intermittent approaches was determined by the measurement timings and times. Of the measurement plans that take one to twenty-four measures daily, the fever detection rate were ranged from 3.3% to 85.0%. The highest detection rates and the corresponding timings of the measurement plans that take measures once, twice, three times, and four times daily were 38.33% (at 20:00), 56.67% (at 3:00, and 19:00/20:00), 65.00% (at 3:00, 20:00, and 22:00/23:00), and 70.00% (at 0:00, 3:00, 20:00, and 23:00), respectively. Although fever within three days after surgery was not correlated with an increased incidence of postoperative complications (18.3% vs. 11.9%, p=0.695), it was correlated with a longer hospital stay (median 7 (IQR 6, 9) vs. median 6 (IQR 5, 7), p<0.001).

Intermittent measurement may never achieve a comparable detection rate with the continuous measurement. However, the fever detection rate at intermittent measurement time points can be improved by adjusting the measurement times.