Other Perioperative Patient Care Issues

Atelectasis as a Cause of Postoperative Fever: Where Is the Clinical Evidence?

Mavros MN, Velmahos GC, Falagas ME (Alfa Inst of Biomedical Sciences, Athens, Greece; Massachusetts General Hosp and Harvard Med School, Boston) Chest 140:418-424, 2011^§

Abstract

Background

Atelectasis is considered to be the most common cause of early postoperative fever (EPF) but the existing evidence is contradictory. We sought to determine if atelectasis is associated with EPF by analyzing the relevant published evidence.

Methods

We performed a systematic search in PubMed and Scopus databases to identify studies examining the association between atelectasis and EPF.

Results

A total of eight studies, including 998 cardiac, abdominal, and maxillofacial surgery patients, were eligible for analysis. Only two studies specifically examined our question, and six additional articles reported sufficient data to be included. Only one study reported a significant association between postoperative atelectasis and fever, whereas the remaining studies indicated no such association. The performance of EPF as a diagnostic test for atelectasis was also assessed, and EPF performed poorly (pooled diagnostic OR, 1.40; 95% CI, 0.92-2.12). The significant heterogeneity among the studies precluded a formal meta analysis.

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