Prevalence and Associated Factors of Postoperative Fever in Pediatric Congenital Heart Surgery: A Systematic Review

Abstract

Context: Post-operative fever in pediatric congenital heart surgery is a common and challenging complication that can affect recovery, hospitalization duration, and healthcare costs. Objectives: This systematic review aimed to investigate the prevalence, associated factors, and management approaches of this condition. Data Sources: A comprehensive search was conducted across Persian (SID, Magiran, IranMedex) and English (PubMed, Scopus, Web of Science) databases. Search keywords included "Post-operative fever", "Congenital heart surgery", and their Persian equivalents. Study Selection: Out of 860 identified articles, 25 studies were selected for the final analysis after screening. The quality of the articles was assessed using the Critical Appraisal Skills Programme (CASP) and AMSTAR tools. Data Extraction: Data were analyzed using RevMan software. Results: The prevalence of post-operative fever in pediatric congenital heart surgeries ranged from 10% to 25%, influenced by factors such as surgery duration, the complexity of congenital defects, patients' nutritional status, and quality of care. More complex and prolonged surgeries showed higher rates of fever. Additionally, biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) were identified as predictive tools for fever risk. Effective management through the use of prophylactic antibiotics, proper nutrition, and close monitoring of patient conditions helped reduce the incidence of this complication. Fever-related outcomes, such as prolonged hospital stays and elevated healthcare costs, were frequently observed. Conclusions: This study highlights the need for multifaceted management of post-operative fever in pediatric congenital heart surgeries. Reducing surgery duration, standardizing management protocols, and improving care quality can help decrease its prevalence. Furthermore, developing comprehensive research in resource-limited areas is recommended to enhance treatment quality and mitigate the negative outcomes of fever.