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Abstract
Introduction. This work aimed to determine the incidence rate, etiologies and predictive factors of post-operative fever (POF) in orthopedics-traumatology in a tropical African context. Patients and method. We carried out a multicenter prospective cohort study. All patients aged 18 years or older, operated on for orthopedic and trauma surgery in 5 University hospitals in Yaoundé from December 1, 2021 to April 31, 2022, and followed for at least 28 days were included in the study. Patients undergoing septic surgery and patients with preoperative fever were excluded. Patients who developed POF were subject to clinical and paraclinical evaluation in search of an etiology for this fever. A multivariate logistic regression was made to determine the predictors of POF. Results. A total of 252 patients were included in the study. These were mainly open reduction and internal fixation of the tibia (40.6%) and the femur (38.9%). The incidence of POF was 39.7%. SSI (29%), malaria (25%), urinary infections (4%) and bronchopulmonary infections (2%) were the most common etiologies of POF. However, in 34% of patients, no etiology was found for POF. A temperature peak on the fifth postoperative day characterized the temperature curve of patients developing SSI. In multivariate analysis, the independent predictive factors for the occurrence of POF were the presence of comorbidities (aOR = 1.77; 95% CI: 1.01-3.11; p = 0.046), blood transfusion (aOR= 2.64, 95% CI: 1.41-4.93; p=0.002) and the soiled appearance of the first dressing (aOR= 2.45; 95% CI: 1.25- 4.79; p=0.009). Conclusion. POF occurs in 39.7% of cases in orthopedic surgery in our context and SSI is the cause in 29% of cases. The analysis of temperature curves could make it possible to detect an SSI early. A temperature peak on the 5th day is highly suspicious and should alert the surgeon
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