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首页> 外文期刊>The American journal of geriatric pharmacotherapy >Cost and Effectiveness of Postoperative Fever Diagnostic Evaluation in Total Joint Arthroplasty Patients
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Cost and Effectiveness of Postoperative Fever Diagnostic Evaluation in Total Joint Arthroplasty Patients

机译：全关节置换患者术后发热诊断评估的成本和效果

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摘要

The purpose of this study is to examine the characteristics and costs of postoperative fever diagnostic evaluations after total joint arthroplasty. All patients who underwent hip and knee arthroplasty (n = 1100) at a single institution for a 2-year period were included. Fever (temperature > =38.5degC) occurred in 15% of patients. The rate of positive tests was as follows: chest radiograph (2%), blood culture (6%), urine culture (22%), and urinalysis (23.7%). Fever occurring after postoperative day 3 (odds ratio [OR] 23.3; P < .001) and multiple days febrile (OR, 8.6; P = .003) are independent predictors of a positive workup, and patients with a maximum temperature of 39.0degC or higher (25.4% vs 6.9%; P = .001) had a significantly higher rate of positive fever evaluations. The total direct cost associated with fever evaluations was dollar73 878, and cost per change in clinical management was dollar8209. Fever is a common occurrence after hip and knee arthroplasty, and many elements of an infectious evaluation are costly and clinically unnecessary.
机译：这项研究的目的是检查全关节置换术后术后发烧诊断评估的特征和费用。包括所有在单一机构接受了两年的髋关节和膝关节置换术（n = 1100）的患者。 15％的患者发烧（温度> = 38.5℃）。阳性检查率如下：胸部X光片（2％），血液培养（6％），尿液培养（22％）和尿液分析（23.7％）。术后第3天发烧（优势比[OR] 23.3; P <.001）和多日发热（OR，8.6; P = .003）是检查阳性的独立预测因子，最高温度为39.0degC或更高（25.4％比6.9％; P = .001）的阳性发烧评估率要高得多。与发烧评估相关的直接总费用为73 878美元，临床管理每次变更的费用为8209美元。发烧是髋关节和膝关节置换术后的常见事件，并且感染评估的许多要素都是昂贵的，并且在临床上是不必要的。

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