Abstract
This retrospective
study explored the association between osteoarthrosis and fever and evaluated
fever-oriented nursing interventions in 30 patients with osteoarthrosis.
Patients were divided into febrile group (n=15,
with ≥1 fever episode) and non-febrile group (n=15, no fever), each further
split into intervention (n=8) and control (n=7) subgroups. Intervention
subgroups received fever-oriented nursing (systematic fever monitoring,
infection screening, anti-inflammatory intervention guidance), while controls
received routine care. Primary outcomes included correlation between
osteoarthrosis severity (Kellgren-Lawrence grade) and fever incidence and
3-month fever recurrence rate. Results showed significant positive correlation
between Kellgren-Lawrence grade and fever incidence (r=0.65, p<0.01).
Intervention subgroups had lower recurrence rates (febrile group: 12.5% vs
61.9%; non-febrile group: 0% vs 35.7%, p<0.05). Fever-oriented nursing
reduces fever-related risks in osteoarthrosis patients, with notable efficacy
in severe cases.
Keywords: Osteoarthrosis; Febrile group and Non-febrile group; Kellgren-lawrence
grade
Introduction
Fever is a non-specific
but clinically meaningful symptom in osteoarthrosis, with 25-35% of
moderate-to-severe cases experiencing episodic fever due to synovial
inflammation or secondary infections1. The breakdown of articular cartilage and subchondral
bone in osteoarthrosis creates a pro-inflammatory microenvironment, which can
manifest as low-grade fever, often misattributed to other causes2. This study investigates the osteoarthrosis-fever
association and evaluates targeted nursing interventions, addressing the lack
of fever-specific care protocols for this population3.
Methods
Study design and
participants
Retrospective analysis of 30 patients with
radiographically confirmed osteoarthrosis (knee: 21 cases, hip: 9 cases).
Inclusion criteria: age 50-80 years; Kellgren-Lawrence grade I-IV; fever
defined as axillary temperature ≥37.3°C lasting >12 hours with no
alternative etiology. Exclusion criteria: autoimmune diseases, acute
infections, malignancy or recent joint surgery.
Grouping & interventions
Control subgroups: Routine care (vital
sign recording, basic symptom management).
Intervention subgroups:
Added fever-oriented interventions: Systematic fever monitoring:
Thrice-daily
temperature measurement, with digital logs tracking fever patterns and
associated symptoms (joint swelling, redness).
Infection screening
education: Teaching patients to distinguish inflammatory vs infectious
fever (e.g., sudden high fever suggesting infection).
Anti-inflammatory
intervention guidance: Timing of non-steroidal anti-inflammatory drug
(NSAID) administration relative to fever onset and cold compress application
protocols.
Laboratory test coordination: Assisting with timely blood culture
and synovial fluid analysis during fever episodes.
Statistical analysis
SPSS 26.0 used for
Pearson correlation, χ² tests and independent t-tests. p<0.05 was
significant.
Results
Osteoarthrosis-fever association and baseline data
Significant positive
correlation between Kellgren-Lawrence grade and fever incidence (r=0.65,
p<0.01). Febrile group had higher initial Kellgren-Lawrence grade and WBC
count (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Febrile Group (n=15) |
Non-Febrile Group (n=15) |
p-value |
|
Age (years, x̄±s) |
65.3±8.7 |
63.8±7.9 |
0.64 |
|
Male gender, n(%) |
8(53.3) |
7(46.7) |
0.73 |
|
Affected joint (knee/hip) |
14/1 |
7/8 |
0.01 |
|
Kellgren-Lawrence grade (x̄±s) |
3.1±0.7 |
1.8±0.6 |
<0.001 |
|
Initial WBC (×10⁹/L, x̄±s) |
9.2±2.1 |
6.8±1.5 |
<0.001 |
• Correlation: Severe osteoarthrosis (Kellgren-Lawrence III-IV) was 3.5 times more likely to be associated with fever (p=0.001).
• Intervention effect: Intervention subgroups showed lower recurrence rates (Table 2).
Table 2: 3-Month Fever Recurrence Rate
|
Group |
Intervention (n=8) |
Control (n=7) |
p-value |
|
Febrile Group |
1(12.5%) |
4(57.1%) |
0.046 |
|
Non-Febrile Group |
0(0%) |
2(28.6%) |
0.049 |
Secondary outcomes
Intervention subgroups
had shorter fever duration, lower peak WBC and fewer readmissions (Table 3).
Table 3: Secondary Outcomes
|
Outcome |
Febrile Group |
Non-Febrile Group |
p-value (intervention effect) |
|
Fever duration (days) |
Intervention:2.8±1.0 |
Intervention:0 |
0.001 |
|
Control:5.9±1.3 |
Control:3.7±1.1 |
- |
|
|
Peak WBC (×10⁹/L) |
Intervention:10.3±1.8 |
Intervention:7.2±1.3 |
<0.001 |
|
Control:13.8±2.2 |
Control:9.5±1.6 |
- |
|
|
Infection-related readmissions |
Intervention:0.1±0.3 |
Intervention:0 |
0.021 |
|
Control:0.7±0.5 |
Control:0.4±0.5 |
- |
Discussion
This study confirms
a strong correlation between osteoarthrosis severity and fever, supporting the
role of advanced joint degeneration in triggering inflammatory responses4. The higher
Kellgren-Lawrence grade in the febrile group aligns with evidence that severe
osteoarthrosis promotes synovial inflammation and increases infection
susceptibility5.
Fever-oriented
nursing interventions reduced recurrence by enhancing early detection-systematic
monitoring identified fever patterns, while education helped distinguish
inflammatory from infectious etiologies6. Coordination of
laboratory tests ensured timely diagnosis, guiding appropriate use of NSAIDs or
antibiotics7. The significant reduction in readmissions
highlights the value of nursing-led surveillance in preventing complications8.
Limitations include
small sample size and reliance on retrospective data. Future studies should
explore biomarkers (e.g., procalcitonin) to refine fever etiology
classification.
Conclusion
Osteoarthrosis severity
correlates significantly with fever incidence. Fever-oriented nursing
interventions effectively reduce fever recurrence, shorten duration and
decrease readmissions by facilitating early detection and targeted management.
These strategies are essential in osteoarthrosis care to address this
underrecognized symptom.
References
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