Abstract: BACKGROUND: Postoperative pyrexia has also been a problem for orthopedic surgeons. 
OBJECTIVE: To analyze the related factors of pyrexia after total hip replacement.
METHODS: The medical records of 140 patients undergoing hip replacement from June 2018 to December 2019 in Northern Jiangsu People’s Hospital  were collected. The body temperature of all patients measured routinely in the hospital was axillary temperature, and postoperative fever was defined as temperature > 38 °C. The relationship between postoperative pyrexia and preoperative, intraoperative and postoperative factors was retrospectively analyzed. Among them, preoperative factors are: age, sex, hypertension, diabetes, body mass index, preoperative hemoglobin, preoperative leukocytes, preoperative albumin, preoperative C-reactive protein, whether to take nonsteroidal anti-inflammatory drugs before surgery, whether it was nebulized before surgery; intraoperative factors: anesthesia method, operation time, and bleeding volume; postoperative factors: postoperative catheterization, postoperative blood transfusion, hemoglobin on the first day after surgery, leukocytes on the first day after surgery, albumin on the first day and C-reactive protein on the first postoperative day.
RESULTS AND CONCLUSION: (1) According to whether there was fever after operation, it was divided into non-pyrexia group (n=100) and pyrexia group (n=40). (2) Univariate analysis results: In the measurement data, the age of non-pyrexia group was higher than that of pyrexia group; the operation time of non-pyrexia group was shorter than that of pyrexia group; and the C-reactive protein of non-pyrexia group was lower than that of pyrexia group on the first day after surgery, and the difference was statistically significant (P < 0.05). In the count data, there were statistical differences between non-pyrexia and pyrexia groups in intraoperative anesthesia and albumin level on the first postoperative day (P < 0.05). (3) The statistically significant single factor was analyzed by multivariate binary logistic regression analysis, and it was found that four independent factors were closely related to fever after hip replacement: operation time (OR=1.024, P=0.032), C-reactive protein on the first postoperative day (OR=1.014, P=0.045), and intraoperative anesthesia method (OR=3.303, P=0.035), and the above indexes were risk factors. The level of albumin on the first postoperative day (OR=0.337, P=0.045) was a protective factor. (4) It is concluded that pyrexia after artificial hip replacement is significantly related to operation time, intraoperative anesthesia method, C-reactive protein on the first postoperative day, and albumin level on the first postoperative day.

Key words: fracture, femoral neck, hip replacement, postoperative fever, anesthesia, albumin, C-reactive protein